Individual
DR. JACOB PETER HOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 662-3311
Mailing address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 662-3311
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.152725
IL
207P00000X
Emergency Medicine Physician
125070487
IL
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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