Healthcare Provider Details
I. General information
NPI: 1346761079
Provider Name (Legal Business Name): JACOB SCHOOF DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2017
Last Update Date: 06/09/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10581 DOUBLE R BLVD
RENO NV
89521-8909
US
IV. Provider business mailing address
10581 DOUBLE R BLVD
RENO NV
89521-8909
US
V. Phone/Fax
- Phone: 575-784-7316
- Fax:
- Phone: 775-982-5437
- Fax: 775-982-6021
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | S4383 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | DO3828 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: