Individual
JACOB BENJAMIN SANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-1230
Mailing address
3635 VISTA AVE, PO BOX 15250, SAINT LOUIS, MO 63110-2539
(314) 577-8780
(314) 577-8516
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01082264A
IN
207P00000X
Emergency Medicine Physician
2017010069
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2014
Last updated
10/14/2020
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