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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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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