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Individual

JACOB CHARLES CHRISTIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
901 HEARTLAND RD, SUITE 2800, ST. JOSEPH, MO 64506-3398
(816) 271-1244
(816) 271-1220
Mailing address
901 HEARTLAND RD STE 2800, SAINT JOSEPH, MO 64506-6201
(816) 271-1200
(816) 271-1220

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2007001552
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200605660A
KS
01
39927012
BLUE CROSS BLUE SHIELD
MO
01
42600018
BLUE CROSS BLUE SHIELD
KS
Enumeration date
09/02/2006
Last updated
11/20/2017
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