Individual
DR. JACOB ANDREW SEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3124 JESSICA ST, JOPLIN, MO 64804-1398
(810) 429-0514
Mailing address
3124 JESSICA ST, JOPLIN, MO 64804-1398
(810) 429-0514
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0538184
KS
2085R0202X
Diagnostic Radiology Physician
Primary
2015014437
MO
2085R0202X
Diagnostic Radiology Physician
34011141
OH
2085R0202X
Diagnostic Radiology Physician
5812
OK
2085R0202X
Diagnostic Radiology Physician
E-13387
AR
2085R0202X
Diagnostic Radiology Physician
OP61464282
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699935064
—
MO
05
—
200590630A
—
OK
Enumeration date
06/10/2008
Last updated
08/30/2024
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