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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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 1437111093 NPPES
Alaska MEDICAID MD1643

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