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General NPI Number Information
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NPI Number | 1083944557
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN PLASTIC SURGERY, INC.
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Dates
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Enumeration Date | 01/06/2010
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 1037 FIRST COLONIAL RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3037
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Country | US
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Telephone | 757-491-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 1037 FIRST COLONIAL RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3037
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Country | US
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Telephone | 757-491-3535
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JONATHAN JACOBS
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Credential | DMD, MD, FACS
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Telephone | 757-491-3535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 0101030062
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License Number State | VA
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