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Individual

JACOB ALLEN BOLT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-5011
(479) 441-4932
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(479) 441-5011
(479) 441-4932

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-13356
AR
207Q00000X
Family Medicine Physician
2019022911
MO
207Q00000X
Family Medicine Physician
E-13356
AR

Other

Enumeration date
06/24/2019
Last updated
12/20/2022
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