Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jeffrey Scott Poulter, MD

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1174521074

Dr. Jeffrey Scott Poulter, MD is a Plastic and Reconstructive Surgery Physician in Bloomington, Illinois. Practices as a sole proprietor. Licensed in Illinois and Missouri.

Licensed in
IL, MO
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1505 Eastland Dr Ste 350
Bloomington, IL 61701-3534
Phone: (309) 663-1222
Fax: (309) 663-0580
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X (IL)
Plastic and Reconstructive Surgery Physician Taxonomy 2086S0122X · Licence MDR5N96 (MO)
Plastic and Reconstructive Surgery Physician Taxonomy 2086S0122X (IL)

Record details

NPI number1174521074
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 13, 2005
Last updated in NPPESDecember 19, 2007