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General NPI Number Information
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NPI Number | 1134106420
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Entity Type | Individual
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Provider Name | RICHARD PAUL JACOBY DPM
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 9475 E IRONWOOD SQUARE DR STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4576
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Country | US
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Telephone | 480-994-5977
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Fax | 480-672-2288
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Provider Business Mailing Address
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Address Line | 4747 N SCOTTSDALE RD STE C4005
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7666
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Country | US
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Telephone | 480-994-5977
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Fax | 480-672-2288
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00084
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License Number State | AZ
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