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1619107273 NPI number — JANIE LOUISE JACOBS M.D.

NPI Number: 1619107273
Health Care Provider/Practitioner: JANIE LOUISE JACOBS M.D.

Information about “1619107273” NPI (JANIE LOUISE JACOBS M.D.) exists in 1619107273 in HTML format HTML  |  1619107273 in plain Text format TXT  |  1619107273 in PDF (Portable Document Format) PDF  |  1619107273 in an XML format XML  formats.

NPI Number : 1619107273 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619107273",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JACOBS",
    "FirstName": "JANIE",
    "MiddleName": "LOUISE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2100 CHERRY HILL DR",
    "SecondLineMailingAddress": "APT 202",
    "MailingAddressCityName": "COLUMBIA",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "65203-5923",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "910-722-6812",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "303 N KEENE ST",
    "SecondLinePracticeLocationAddress": "SUITE 404",
    "PracticeLocationAddressCityName": "COLUMBIA",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "65201-7193",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "573-777-7627",
    "PracticeLocationAddressFaxNumber": "573-777-4596",
    "EnumerationDate": "07/16/2009",
    "LastUpdateDate": "07/29/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208000000X",
        "TaxonomyName": "Pediatrics Physician",
        "LicenseNumber": "2013017670",
        "LicenseNumberStateCode": "MO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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