Jacoby, Robert G
Jacoby, Robert G is an individual health care provider with primary practice located at 11091 Ulysses Street Suite 100, Blaine MN 55434. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Jacoby, Robert G can be contacted via phone (612) 879-1000.Contact Information
Primary practice address
11091 Ulysses Street Suite 100
Blaine MN 55434
Phone: (612) 879-1000
Fax: (612) 879-0782
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD2023-0126 | New Mexico |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 37807 | Minnesota |
Profile Details
| NPI number | 1518961531 |
|---|---|
| LBN Legal business name | Jacoby, Robert G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2005 |
| Last updated | Apr 13th, 2023 - about 2 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 | 1518961531 | NPPES |
| Minnesota | MEDICAID | 160230600 |
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