Jacob, Jack
Jacob, Jack is an individual health care provider with primary practice located at 3340 Providence Dr Suite 366, Anchorage AK 99508-4616. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Jacob, Jack can be contacted via phone (907) 563-3026.Contact Information
Primary practice address
3340 Providence Dr Suite 366
Anchorage AK 99508-4616
Phone: (907) 563-3026
Fax: (907) 562-6445
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 1643 | Alaska |
Profile Details
NPI number | 1437111093 |
---|---|
LBN Legal business name | Jacob, Jack |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 6th, 2006 |
Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1437111093 | NPPES |
Alaska | MEDICAID | MD1643 |
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