Jaco, Jacob

Jaco, Jacob is an sole proprietor health care provider with primary practice located at 10455 Orthopaedic Dr , Newburgh IN 47630-7955. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jaco, Jacob can be contacted via phone (812) 424-9291.

Contact Information

Primary practice address
10455 Orthopaedic Dr Newburgh IN 47630-7955
Phone: (812) 424-9291
Fax: (812) 421-2722
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2736 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10002987A Indiana

Profile Details

NPI number 1639788326
LBN Legal business name Jaco, Jacob
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2020
Last updated Mar 15th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639788326 NPPES
Indiana Other 10002987A STATE LICENSE
Indiana MEDICAID 300044870 STATE LICENSE
Indiana Other PA2736 STATE LICENSE
Indiana Other 847950029 STATE LICENSE

Popular Providers