JACOB STAFFORD EDMISSON

INDIANAPOLIS, IN
NPI1609444967
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: IN  11023782A)
Additional Taxonomies207R00000X Internal Medicine
(Licence: MO  2021021803)
Enumeration Date2021-06-14
Last Update Date2024-06-18
Business Address
Dr. JACOB STAFFORD EDMISSON MD
535 BARNHILL DR
INDIANAPOLIS, IN 46202-5116
Phone number: 317-948-6942
Mailing Address
Dr. JACOB STAFFORD EDMISSON MD
535 BARNHILL DR
INDIANAPOLIS, IN 46202-5116
Phone number: 317-948-6942