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General NPI Number Information
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NPI Number | 1699262998
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Entity Type | Individual
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Provider Name | JACOB PAUL FELTON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 10 DONALD B DEAN DR STE 3
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-3372
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Country | US
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Telephone | 207-910-0771
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Fax | 207-910-0772
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Provider Business Mailing Address
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Address Line | 6 BRIDLE PATH WAY
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City | CAPE ELIZABETH
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State | ME
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Zip | 04107-1802
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Country | US
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Telephone | 402-301-7136
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR27919
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14693
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License Number State | NE
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