Jacob, Jack

Jacob, Jack is an individual health care provider with primary practice located at 3525 Prytania Street Suite 206, New Orleans LA 70115. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Jacob, Jack can be contacted via phone (504) 897-8281.

Contact Information

Primary practice address
3525 Prytania Street Suite 206 New Orleans LA 70115
Phone: (504) 897-8281
Fax: (504) 897-5604
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 011071 Louisiana
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 011071 Louisiana

Profile Details

NPI number 1255482063
LBN Legal business name Jacob, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Mar 6th, 2019 - about 6 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255482063 NPPES
Louisiana MEDICAID 1943479
Louisiana MEDICAID 1133191

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