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NPI Code Detail

MEDICARE: DR. ABRAHAM JACOB M.D.

MEDICARE: DR. ABRAHAM JACOB M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207YX0901XOtology & Neurotology Physician44630AZ

General Provider Information

NPI Number : 1376592576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABRAHAM JACOB M.D.
Provider Business Mailing Address
First Line : 2450 E RIVER RD
Second Line :
City : TUCSON
State : AZ
Zip : 85718-6526
Country : US
Telephone Number : 520-795-7750
Fax Number : 520-320-2155
Provider Business Practice Location Address
First Line : 2450 E RIVER RD
Second Line :
City : TUCSON
State : AZ
Zip : 85718-6526
Country : US
Telephone Number : 520-795-7750
Fax Number : 520-320-2155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 03/10/2021

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