Jacobs, Alicia A
Jacobs, Alicia A is an individual health care provider with primary practice located at 883 Blakely Rd , Colchester VT 05446-4417. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jacobs, Alicia A can be contacted via phone (802) 847-2055.Contact Information
Primary practice address
883 Blakely Rd
Colchester VT 05446-4417
Phone: (802) 847-2055
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0420009645 | Vermont |
Profile Details
| NPI number | 1154355386 |
|---|---|
| LBN Legal business name | Jacobs, Alicia A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Aug 26th, 2011 - about 13 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 | 1154355386 | NPPES |
| New York | MEDICAID | 02212146 | |
| New York | MEDICAID | OVN2031 |
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