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General NPI Number Information
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NPI Number | 1023054442
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Entity Type | Organization
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Legal Business Name | ALLAN JACOBS MD PD
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 70 MARKET ST SUITE #4
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City | POTSDAM
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State | NY
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Zip | 13676-1896
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Country | US
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Telephone | 315-265-1721
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Fax | 315-265-0157
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Provider Business Mailing Address
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Address Line | 70 MARKET ST SUITE #4
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City | POTSDAM
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State | NY
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Zip | 13676-1896
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Country | US
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Telephone | 315-265-1721
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Fax | 315-265-0157
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLAN JACOBS
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Credential | MD
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Telephone | 315-265-1721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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