Jacobs, Richard Allen
Jacobs, Richard Allen is an sole proprietor health care provider with primary practice located at 619 S Washington St Ste 202, Moscow ID 83843-3090. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Jacobs, Richard Allen can be contacted via phone (208) 882-1522.Contact Information
Primary practice address
619 S Washington St Ste 202
Moscow ID 83843-3090
Phone: (208) 882-1522
Fax: (208) 882-1527
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | M3665 | Idaho |
Profile Details
| NPI number | 1457333668 |
|---|---|
| LBN Legal business name | Jacobs, Richard Allen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Jun 28th, 2010 - about 16 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 | 1457333668 | NPPES |
| Idaho | Other | 362964260 | TAX ID |
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