person
Jacob B Wall, PA-C
Surgical Physician Assistant in Bloomington, Indiana
NPI 1932770005

Jacob B Wall is a Surgical Physician Assistant based in Manitowoc, IN and is specialized in Surgical. Jacob B Wall practices in Bloomington, IN and has the professional credentials of PA-C. The NPI Number for Jacob B Wall is 1932770005 and holds a License No. 10003433A (Indiana).

The current practice location address for Jacob B Wall is 415 S Landmark Ave, Bloomington, IN and can be reached out via phone at 812-333-7433 and via fax at 812-333-7435. You can also correspond with Jacob B Wall through the mailing address at 801 YORK ST, MANITOWOC, WI - 54220-4630 (mailing address contact number: 920-663-9008).

Location: 415 S Landmark Ave, Bloomington, IN, 54220-4630
person
Provider Profile Details
NPI Number
1932770005
Provider Name
Jacob B Wall
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
415 S Landmark Ave, Bloomington, IN, 54220-4630
Phone Number
812-333-7433
Fax Number
812-333-7435
Provider Enumeration Date
07/08/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
415 S Landmark Ave
City
State
Zip
47403-5003
Phone Number
812-333-7433
Fax Number
812-333-7435
person
Provider Business Mailing Address Details
Address
415 S Landmark Ave
City
State
Zip
47403-5003
Phone Number
812-333-7433
Fax Number
812-333-7435
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
10003433A (Indiana)
Definition
Definition to come...
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