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General NPI Number Information
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NPI Number | 1164458907
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Entity Type | Individual
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Provider Name | JONATHAN T. JACOBS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 5701 W 119TH ST STE 419
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City | OVERLAND PARK
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State | KS
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Zip | 66209-3721
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Country | US
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Telephone | 913-498-1444
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Fax | 913-667-2759
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Provider Business Mailing Address
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Address Line | 5701 W 119TH ST STE 419
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City | OVERLAND PARK
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State | KS
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Zip | 66209-3721
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Country | US
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Telephone | 913-498-1444
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Fax | 913-667-2759
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0429916
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0429916
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2002028986
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 04-29916
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2002028986
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 04-29916
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License Number State | KS
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Taxonomy #7
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2002028986
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License Number State | MO
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