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DR. JEFFREY SCOTT POULTER M.D. NPI 1174521074


NPI Information

NPI: 1174521074
Provider Name: DR. JEFFREY SCOTT POULTER, M.D.
Classification: Plastic Surgery - 208200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1505 EASTLAND DR
STE 350
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 663-1222
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DR. Jeffrey Scott Poulter, M.D. is a plastic surgery in Bloomington, IL. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. DR. Jeffrey Scott Poulter, M.D. NPI is 1174521074. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1505 EASTLAND DR
STE 350
BLOOMINGTON, IL
ZIP 61701-534
Phone: (309) 663-1222
Fax: (309) 663-0580

The NPI 1174521074 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 12/19/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0122XSurgeryPlastic and Reconstructive SurgeryMDR5N96MISSOURINo
22086S0122XSurgeryPlastic and Reconstructive SurgeryILLINOISNo
3208200000XPlastic SurgeryILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F27055MEDICARE UPINILLINOIS
2F27055MEDICARE UPIN
3976430MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.