Jacob, Kenneth Michael
Jacob, Kenneth Michael is an sole proprietor health care provider with primary practice located at 19460 Caladesi Dr , Fort Myers FL 33967-5572. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jacob, Kenneth Michael can be contacted via phone (913) 707-0826.Contact Information
Primary practice address
19460 Caladesi Dr
Fort Myers FL 33967-5572
Phone: (913) 707-0826
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | R3D70 | Missouri |
Profile Details
| NPI number | 1437121829 |
|---|---|
| LBN Legal business name | Jacob, Kenneth Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 1st, 2006 |
| Last updated | Nov 13th, 2013 - about 12 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 | 1437121829 | NPPES |
| Kansas | MEDICAID | 100154570D | |
| Kansas | Other | 12485021 | |
| Kansas | MEDICAID | 203728035 |
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