Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JEFFREY SCOTT POULTER, M.D.

Active Sole Proprietor

DR. JEFFREY SCOTT POULTER, M.D. is a Plastic Surgery healthcare provider located in BLOOMINGTON, Illinois. NPI 1174521074 is currently active in the NPPES registry. Verify at CMS.

Plastic Surgery · BLOOMINGTON, IL

Registration Details

NPI Number: 1174521074
Provider Type: Individual
Gender: Male
NPI Issued: Jul 13, 2005 (20.944167058595 yrs)
Last Updated: Dec 19, 2007
License: MDR5N96 (MO)
Sole Proprietor: Yes

Practice Information

Address: 1505 EASTLAND DR

STE 350

BLOOMINGTON, IL, 617013534
Browse IL providers · Browse ZIP 61701
Phone: 3096631222
Fax: 3096630580
Primary Specialty: Plastic Surgery
208200000X
Additional Specialty: Plastic Surgery
Additional Specialty: Plastic and Reconstructive Surgery

Other Plastic Surgery Providers in BLOOMINGTON, IL

Name	Credential	NPI
DR. OTIS GEORGE ALLEN	M.D.	1306847900
DR. PAIGE C. HOLT	MD	1821026519
DR. CHAD TATTINI	—	1992721005
DR. LAURA C RANDOLPH	M.D.	1710906557

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.