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

POTHEN JACOB, MD

Active

Pediatrics · E ST LOUIS, IL

Registration Details

NPI Number: 1376640474
Provider Type: Individual
Gender: Male
NPI Issued: Sep 20, 2006 (19.619389526848 yrs)
Last Updated: Jul 8, 2007
License: 3648725 (IL)

Practice Information

Address: 4601 STATE ST

SUITE #210

E ST LOUIS, IL, 622051359
Browse IL providers · Browse ZIP 62205
Phone: 6188743700
Fax: 6188745031
Primary Specialty: Pediatrics
208000000X

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.