MEDICARE: DR. JACQUE CURTIS 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
1	207R00000X	Internal Medicine Physician	MD055881L	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598784324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUE CURTIS M.D.

Provider Business Mailing Address
First Line	:	101 E OLNEY AVE STE 40
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19120-2421
Country	:	US
Telephone Number	:	215-456-1825
Fax Number	:	215-456-5926

Provider Business Practice Location Address
First Line	:	7131 FRANKFORD AVE # 39
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-1008
Country	:	US
Telephone Number	:	215-332-4164
Fax Number	:	215-332-9638

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/13/2025

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