Wall, Jeffrey A

Wall, Jeffrey A is an individual health care provider with primary practice located at 190 Stetson Rd , Auburn ME 04210-7813. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wall, Jeffrey A can be contacted via phone (207) 784-7388.

Contact Information

Primary practice address
190 Stetson Rd Auburn ME 04210-7813
Phone: (207) 784-7388
Fax: (207) 795-2043
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1877 Maine

Profile Details

NPI number 1447288808
LBN Legal business name Wall, Jeffrey A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Mar 24th, 2017 - about 8 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1447288808 NPPES
Maine Other 048350 ANTHEM
Maine Other 9386763 ANTHEM
Maine Other 9759878 ANTHEM
Maine Other 3769958 ANTHEM
Maine MEDICAID 431799199 ANTHEM

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