Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 101535 | MO |
NPI | 1245494665 |
---|---|
Provider Name | Dr. Jeffrey A Wool |
First Address | Joplin, MO 64804-2925 |
Second Address | Joplin, MO 64804-2925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 15/07/2008 |