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NPI Code Detail

MEDICARE: DR. JAMIE J. JACOBS MD

MEDICARE: DR. JAMIE J. JACOBS 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
1207RC0000XCardiovascular Disease Physician16157KY
2207RI0011XInterventional Cardiology Physician16157KY

General Provider Information

NPI Number : 1578575254
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMIE J. JACOBS MD
Provider Business Mailing Address
First Line : 1401 HARRODSBURG RD STE A300
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3787
Country : US
Telephone Number : 859-276-4429
Fax Number : 859-276-5910
Provider Business Practice Location Address
First Line : 1401 HARRODSBURG RD STE A300
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3787
Country : US
Telephone Number : 859-276-4429
Fax Number : 859-276-5910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 07/16/2007

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