Wall, Jacob B
Wall, Jacob B is an individual health care provider with primary practice located at 415 S Landmark Ave , Bloomington IN 47403-5003. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Wall, Jacob B can be contacted via phone (812) 333-7433.Contact Information
Primary practice address
415 S Landmark Ave
Bloomington IN 47403-5003
Phone: (812) 333-7433
Fax: (812) 333-7435
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 10003433A | Indiana |
Profile Details
| NPI number | 1932770005 |
|---|---|
| LBN Legal business name | Wall, Jacob B |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2021 |
| Last updated | Jan 30th, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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