Short, Jacob M

Short, Jacob M is an individual health care provider with primary practice located at 5170 Us Route 60 , Huntington WV 25705-2004. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Short, Jacob M can be contacted via phone (304) 528-4600.

Contact Information

Primary practice address
5170 Us Route 60 Huntington WV 25705-2004
Phone: (304) 528-4600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1310 West Virginia

Profile Details

NPI number 1447447503
LBN Legal business name Short, Jacob M
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2007
Last updated Mar 31st, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447447503 NPPES
West Virginia MEDICAID 1447447503
West Virginia MEDICAID 0356376
West Virginia MEDICAID 7100109200

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