Mark Jacobs, PA
Physician Assistant in Modesto, CA. Individual provider (NPI-1).
NPI number1346359866
StatusActive
Last updated in NPPESApr 4, 2024
Details
- NPI
- 1346359866
- Entity type
- Individual (NPI-1)
- Name
- Mark Jacobs
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 29, 2006
- Certification date
- Apr 4, 2024
- Last updated
- Apr 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA.1502 | AL | Yes |
| 363A00000X | Physician Assistant | 15-01583 | KS |
Practice location
1541 Florida Ave Ste 305Modesto, CA 95350-4439
Phone 209-575-5833 · Fax 209-575-5836
Mailing address
Po Box 909Louisville, KY 40201-0909
Phone 502-588-0328 · Fax 502-588-0326
Other practice locations
201 Abraham Flexner Way Ste 1200
Louisville, KY 40202-3841
Louisville, KY 40202-3841
Phone 502-588-7600 · Fax 502-588-7700
833 Princeton Ave Sw Ste 200a
Birmingham, AL 35211-1321
Birmingham, AL 35211-1321
Phone 205-786-2776
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All 127 Physician Assistant providers in Modesto · All 10,803 providers in Modesto
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