Jacoby, Russell F
Jacoby, Russell F is an sole proprietor health care provider with primary practice located at 3108 Ponte Morino Drive Palmer Professional Centre Suite 230, Cameron Park CA 95682-5022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Jacoby, Russell F can be contacted via phone (530) 672-2701.Contact Information
Primary practice address
3108 Ponte Morino Drive Palmer Professional Centre Suite 230
Cameron Park CA 95682-5022
Phone: (530) 672-2701
Fax: (530) 672-9097
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 32200 | Wisconsin |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | G86695 | California |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 36071501 | Illinois |
Profile Details
| NPI number | 1700852878 |
|---|---|
| LBN Legal business name | Jacoby, Russell F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2006 |
| Last updated | Feb 4th, 2008 - about 16 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 | 1700852878 | NPPES |
| Wisconsin | MEDICAID | 31708100 |
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