Individual
JACOB A. LANDVATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
849 KELLOGG AVE, JANESVILLE, WI 53546-2808
(608) 755-7960
(608) 755-7873
Mailing address
849 KELLOGG AVE, JANESVILLE, WI 53546-2808
(608) 755-7960
(608) 755-7873
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
60134
AZ
208M00000X
Hospitalist Physician
Primary
60134
AZ
Other
Enumeration date
04/23/2018
Last updated
10/15/2020
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