MEDICARE: JACOB LAYFIELD

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
1	363A00000X	Physician Assistant	5671883	ID
2	363A00000X	Physician Assistant	62136	CA
3	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1366105777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB LAYFIELD

Provider Business Mailing Address
First Line	:	42006 W ANNE LN
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85138-8637
Country	:	US
Telephone Number	:	443-880-0082
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 E STILL CIR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-3618
Country	:	US
Telephone Number	:	480-219-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2021
Last Update Date	:	03/02/2026

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Directions to “ JACOB LAYFIELD ” Practice Location

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