Individual
JACOB DAVID SAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 ASHLAND AVE., MT. ZION, IL 62549
(217) 864-2665
(217) 864-8042
Mailing address
PO BOX 9632, SPRINGFIELD, IL 62791-9632
(217) 864-2665
(217) 864-8042
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036132006
IL
Other
Enumeration date
06/24/2008
Last updated
02/23/2022
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