MEDICARE: DAVID C JACOBS MD

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	207R00000X	Internal Medicine Physician	37385	TN
2	207RC0000X	Cardiovascular Disease Physician	37385	TN
3	208M00000X	Hospitalist Physician	37385	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00400975	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6010930	OTHER	TN	BLUE CROSS-BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4154142	OTHER	TN	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4064306	OTHER	TN	BLUE CROSS BLUE SHIELD
7	0007460476	OTHER		AETNA

General Provider Information

NPI Number	:	1952386393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C JACOBS MD

Provider Business Mailing Address
First Line	:	501 GREAT CIRCLE RD
Second Line	:	SUITE 200
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1317
Country	:	US
Telephone Number	:	615-222-6977
Fax Number	:	615-222-5322

Provider Business Practice Location Address
First Line	:	4220 HARDING RD
Second Line	:	SUITE 500
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2005
Country	:	US
Telephone Number	:	615-222-6977
Fax Number	:	615-222-5322

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	10/17/2014

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Directions to “ DAVID C JACOBS MD” Practice Location

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