NPI 1245579200

Jacob Andrew Walters, PAC

Practitioner Physician Assistant Ozark, MO

Practice location

Address: 3050 E River Bluff Blvd, Ozark, MO 65721-8807
Phone: (417) 885-3000
Fax: (717) 737-7197

Registered specialties (4)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2021024722 (MO)

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Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence MA055982 (PA)

Medical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence MA055982 (PA)

Surgical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence MA055982 (PA)

Registry record

NPI: 1245579200
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Feb 2013
Record last updated: 18 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.