Individual
DR. JACOB CHARLES LISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6545 FRANCE AVENUE SOUTH, SUITE 510, EDINA, MN 55435
(952) 927-7079
(952) 920-9758
Mailing address
6545 FRANCE AVENUE SOUTH, SUITE 510, EDINA, MN 55435
(952) 927-7079
(952) 920-9758
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50056
MN
Other
Enumeration date
05/03/2007
Last updated
01/07/2008
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