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NPI Code Detail

MEDICARE: DR. JACOB LANCE HEATH D.O.

MEDICARE:  DR. JACOB LANCE HEATH  D.O.
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
1207Q00000XFamily Medicine Physician0102204678VA

General Provider Information

NPI Number : 1528449303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB LANCE HEATH D.O.
Provider Business Mailing Address
First Line : LANDSTUHL REGIONAL MEDICAL CENTER, UNIT 33100
Second Line :
City : APO
State : AE
Zip : 09180-3100
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : LANDSTUHL REGIONAL MEDICAL CENTER
Second Line : UNIT 33100
City : APO
State : AE
Zip : 09180-3100
Country : US
Telephone Number : 314-324-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 05/26/2026

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Directions to “ DR. JACOB LANCE HEATH D.O.” Practice Location

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