Jacobs, Bradley Edgar

Jacobs, Bradley Edgar is an individual health care provider with primary practice located at 2927 Lyndhurst Ave , Winston-Salem NC 27103-4005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Jacobs, Bradley Edgar can be contacted via phone (336) 765-9350.

Contact Information

Primary practice address
2927 Lyndhurst Ave Winston-Salem NC 27103-4005
Phone: (336) 765-9350
Fax: (336) 760-4255
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 9801681 North Carolina

Profile Details

NPI number 1194721498
LBN Legal business name Jacobs, Bradley Edgar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Nov 16th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194721498 NPPES
North Carolina MEDICAID 891280K
North Carolina Other 1280K

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