Individual
DR. JACOB LEE SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2000
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2009003438
MO
207P00000X
Emergency Medicine Physician
4301087626
MI
Other
Enumeration date
06/05/2007
Last updated
05/16/2013
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