Individual
JACOB E MEFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5522
Mailing address
DEPT 960347, OKLAHOMA CITY, OK 73196-0347
(800) 684-0062
(405) 844-1794
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004403
IL
Other
Enumeration date
08/30/2012
Last updated
01/30/2013
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