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NPI Code Detail

MEDICARE: MR. JACOB THOMAS MORMAN

MEDICARE: MR. JACOB THOMAS MORMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician35.156147OH

General Provider Information

NPI Number : 1184327512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACOB THOMAS MORMAN
Provider Business Mailing Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-4225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2023
Last Update Date : 06/09/2026

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Directions to “ MR. JACOB THOMAS MORMAN ” Practice Location

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