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NPI Code Detail

MEDICARE: YEWANDE JACOBS

MEDICARE: YEWANDE JACOBS
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
1225X00000XOccupational TherapistOTOO2846GA

General Provider Information

NPI Number : 1437559176
Entity Type Code : Individual
Provider Name (Legal Business Name) : YEWANDE JACOBS
Provider Business Mailing Address
First Line : 3653 HUDDLESTONE LN
Second Line :
City : BUFORD
State : GA
Zip : 30519-4649
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1263 COBB PKWY N
Second Line :
City : MARIETTA
State : GA
Zip : 30062-2421
Country : US
Telephone Number : 770-852-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2014
Last Update Date : 11/28/2025

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