Jacoby, Michael R

Jacoby, Michael R is an individual health care provider with primary practice located at 403 W Highland Blvd , Inverness FL 34452-4717. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jacoby, Michael R can be contacted via phone (352) 726-3646.

Contact Information

Primary practice address
403 W Highland Blvd Inverness FL 34452-4717
Phone: (352) 726-3646
Fax: (352) 726-0079
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036046008 Illinois
Allopathic & Osteopathic Physicians / Surgery 208600000X 54194-20 Wisconsin
Allopathic & Osteopathic Physicians / Surgery 208600000X ME105854 Florida

Profile Details

NPI number 1811911993
LBN Legal business name Jacoby, Michael R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Apr 3rd, 2017 - about 8 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 1811911993 NPPES
Illinois Other 04929950 BC BS
Illinois MEDICAID 036046008 BC BS

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