MEDICARE: PREMA M JACOB MD

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
1	207Q00000X	Family Medicine Physician	43958	CO
2	207Q00000X	Family Medicine Physician	25MA04062800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487633533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PREMA M JACOB MD

Provider Business Mailing Address
First Line	:	4674 SNOW MESA DRIVE
Second Line	:	SUITE 140
City	:	FORT COLLINS
State	:	CO
Zip	:	80528
Country	:	US
Telephone Number	:	970-225-5010
Fax Number	:	970-482-9646

Provider Business Practice Location Address
First Line	:	3850 GRANT AVE
Second Line	:	SUITE 100
City	:	LOVELAND
State	:	CO
Zip	:	80538-8431
Country	:	US
Telephone Number	:	970-776-1862
Fax Number	:	970-482-9646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	11/25/2015

Similar Medicare Providers

1326870858 — HOLLY GREGORY
Practice Location Address:

3850 GRANT AVE
LOVELAND, CO
80538-8431

Practice Phone: 518-244-3737
Practice Fax: 518-244-5292

1922087238 — MR. VICTOR PALOMARES P.A.
Practice Location Address:

3850 N GRANT AVE , SUITE 200
LOVELAND, CO
80538-8431

Practice Phone: 970-624-5170
Practice Fax: 970-669-7521

1598737975 — MS. KIMBERLY RACINE PA-C
Practice Location Address:

3850 N GRANT AVE STE 200
LOVELAND, CO
80538-8431

Practice Phone: 970-624-5170
Practice Fax: 970-669-7521

1013023662 — ADVANCED PSYCHIATRY OF COLORADO, P.C.
Practice Location Address:

3850 GRANT AVE , SUITE 100
LOVELAND, CO
80538-8431

Practice Phone: 970-292-5988
Practice Fax:

1982813093 — MRS. JILL AMANDA HARTMAN PA-C
Practice Location Address:

3850 GRANT AVE STE 200
LOVELAND, CO
80538-8431

Practice Phone: 970-624-5150
Practice Fax: 970-669-7750

1134326085 — LOVELAND URGENT CARE
Practice Location Address:

3850 N GRANT AVE , SUITE 100
LOVELAND, CO
80538-8431

Practice Phone: 970-669-5717
Practice Fax: 970-669-7750

Directions to “ PREMA M JACOB MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.