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NPI Code Detail

MEDICARE: JEFFREY SCOTT HOLBROOK

MEDICARE: JEFFREY SCOTT HOLBROOK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1861240905
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY SCOTT HOLBROOK
Provider Business Mailing Address
First Line : 2701 17TH ST
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-5351
Country : US
Telephone Number : 309-779-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2701 17TH ST
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-5351
Country : US
Telephone Number : 309-779-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2024
Last Update Date : 01/30/2026

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Directions to “ JEFFREY SCOTT HOLBROOK ” Practice Location

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