Jacobs, Theresa R
Jacobs, Theresa R is an individual health care provider with primary practice located at 868 York Ave Sw , Atlanta GA 30310-2750. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jacobs, Theresa R can be contacted via phone (404) 752-1400.Contact Information
Primary practice address
868 York Ave Sw
Atlanta GA 30310-2750
Phone: (404) 752-1400
Fax: (404) 758-0740
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 046864 | Georgia |
Profile Details
| NPI number | 1013978105 |
|---|---|
| LBN Legal business name | Jacobs, Theresa R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Feb 20th, 2014 - about 11 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 | 1013978105 | NPPES |
| Georgia | MEDICAID | 000873188A |
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