Jacobi, Diane Jean

Jacobi, Diane Jean is an individual health care provider with primary practice located at 809 Medical Park Dr Suite 101, Mexico MO 65265. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Jacobi, Diane Jean can be contacted via phone (573) 581-8590.

Contact Information

Primary practice address
809 Medical Park Dr Suite 101 Mexico MO 65265
Phone: (573) 581-8590
Fax: (573) 473-3706
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 113579 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 113579 Missouri

Profile Details

NPI number 1912983560
LBN Legal business name Jacobi, Diane Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Jun 28th, 2022 - about 2 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 1912983560 NPPES
Missouri MEDICAID 209683002

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