Jacobs, Kevin
Jacobs, Kevin is an individual health care provider with primary practice located at 1905 Abbot Rd Ste 1 , East Lansing MI 48823-8571. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Jacobs, Kevin can be contacted via phone (517) 580-8733.Contact Information
Primary practice address
1905 Abbot Rd Ste 1
East Lansing MI 48823-8571
Phone: (517) 580-8733
Fax: (517) 337-1854
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 4901004013 | Michigan |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 4901004013 | Michigan |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 4901004013 | Michigan |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004013 | Michigan |
Profile Details
| NPI number | 1801840657 |
|---|---|
| LBN Legal business name | Jacobs, Kevin |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | Jan 12th, 2021 - about 3 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 | 1801840657 | NPPES |
| Michigan | Other | 22-70122 | PHP-MEDICAID |
| Michigan | MEDICAID | 86-4792288 | PHP-MEDICAID |
| Michigan | Other | 22-00122 | PHP-MEDICAID |
| Michigan | Other | 900C313100 | PHP-MEDICAID |
| Michigan | Other | 1019456 | PHP-MEDICAID |
| Michigan | MEDICAID | 94-4318770 | PHP-MEDICAID |
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