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:
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Health care specialties

SpecialtyCodeLicense #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 10 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 1013978105 NPPES
Georgia MEDICAID 000873188A

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