Jacobs, Michael A

Jacobs, Michael A is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142-7884. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jacobs, Michael A can be contacted via phone (262) 948-5600.

Contact Information

Primary practice address
10400 75Th St Kenosha WI 53142-7884
Phone: (262) 948-5600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1170-023 Wisconsin

Profile Details

NPI number 1700993227
LBN Legal business name Jacobs, Michael A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Mar 7th, 2023 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1700993227 NPPES
Wisconsin MEDICAID 42987800

Popular Providers