Jacobs, Mark A

Jacobs, Mark A is an individual health care provider with primary practice located at 3810 S Highway 27 Suite 1, Somerset KY 42501-3073. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jacobs, Mark A can be contacted via phone (606) 678-4551.

Contact Information

Primary practice address
3810 S Highway 27 Suite 1 Somerset KY 42501-3073
Phone: (606) 678-4551
Fax: (606) 678-0972
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1201DT Kentucky

Profile Details

NPI number 1124023809
LBN Legal business name Jacobs, Mark A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Dec 3rd, 2019 - about 5 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 1124023809 NPPES
Kentucky Other 410028407 RAILROAD MEDICARE
Kentucky Other 380000269 RAILROAD MEDICARE
Kentucky MEDICAID 7100209960 RAILROAD MEDICARE
Kentucky Other 127554 RAILROAD MEDICARE
Kentucky MEDICAID 4599154 RAILROAD MEDICARE
Kentucky MEDICAID 7100209970 RAILROAD MEDICARE
Kentucky Other 00160523 RAILROAD MEDICARE
Kentucky MEDICAID 77012011 RAILROAD MEDICARE

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