Healthcare Provider Details

I. General information

NPI: 1023209772
Provider Name (Legal Business Name): RICHARD P. JACOBS, M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 S AIKEN AVE SUITE 414
PITTSBURGH PA
15232-1521
US

IV. Provider business mailing address

532 S AIKEN AVE SUITE 414
PITTSBURGH PA
15232-1521
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-6632
  • Fax: 412-681-8760
Mailing address:
  • Phone: 412-681-6632
  • Fax: 412-681-8760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD P JACOBS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 412-681-6632