Individual
JACOB MARTIN EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
336 S JEFFERSON ST, NEOSHO, MO 64850-1769
(417) 455-4200
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-4662
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2017018496
MO
Other
Enumeration date
06/30/2017
Last updated
03/11/2026
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