Individual
BEN L JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 E PROMENADE ST, MEXICO, MO 65265-2966
(573) 582-6831
(573) 582-3220
Mailing address
515 E PROMENADE ST, MEXICO, MO 65265-2966
(573) 582-6831
(573) 582-3220
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36087
MO
Other
Enumeration date
05/19/2006
Last updated
02/13/2009
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