Jacobus, Brent A

Jacobus, Brent A is an individual health care provider with primary practice located at 9150 E 109Th Ave Ste 2A Crown Point, Crown Point IN 46307-7686. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jacobus, Brent A can be contacted via phone (219) 226-1529.

Contact Information

Primary practice address
9150 E 109Th Ave Ste 2A Crown Point Crown Point IN 46307-7686
Phone: (219) 226-1529
Fax: (219) 226-2994
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001090 Indiana

Profile Details

NPI number 1902807589
LBN Legal business name Jacobus, Brent A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Nov 1st, 2011 - about 14 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 1902807589 NPPES
Indiana MEDICAID 100200720

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