MEDICARE: MR. TAD JACOBS DO

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	1258	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	57028A004	OTHER	SD	WPS TRICARE
2	1258	OTHER	SD	DAKOTACARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	12967	OTHER	SD	MIDLANDS CHOICE
5	68890	OTHER	SD	ARAZ/AMERICA'S PPO
6	AH908107523	OTHER	SD	PREFERRED ONE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	4995979	OTHER	SD	BCBS OF SOUTH DAKOTA
9	659S6JA	OTHER	MN	BCBS OF MN
10	659S 6JA	OTHER	MN	CC SYSTEMS BLUE PLUS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629044458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAD JACOBS DO

Provider Business Mailing Address
First Line	:	111 E 10TH ST
Second Line	:
City	:	DELL RAPIDS
State	:	SD
Zip	:	57022-1217
Country	:	US
Telephone Number	:	605-428-5446
Fax Number	:	605-428-2333

Provider Business Practice Location Address
First Line	:	111 E 10TH ST
Second Line	:
City	:	DELL RAPIDS
State	:	SD
Zip	:	57022-1217
Country	:	US
Telephone Number	:	605-997-2471
Fax Number	:	605-997-2418

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	07/08/2016

Similar Medicare Providers

1104082288 — MRS. JULIA AGNES ABRAHAM PA-C
Practice Location Address:

111 E 10TH ST
DELL RAPIDS, SD
57022-1217

Practice Phone: 605-428-5446
Practice Fax: 605-428-2333

1487322764 — MR. JOSHUA HUGHES PA-C
Practice Location Address:

111 E 10TH ST
DELL RAPIDS, SD
57022-1217

Practice Phone: 605-428-5446
Practice Fax:

1164137592 — RACHEL KRAMER CNP
Practice Location Address:

111 E 10TH ST
DELL RAPIDS, SD
57022-1217

Practice Phone: 605-428-5446
Practice Fax:

1689553729 — ALEC MICHAEL BAKER PA-C
Practice Location Address:

111 E 10TH ST
DELL RAPIDS, SD
57022-1217

Practice Phone: 605-428-5446
Practice Fax:

1225058233 — DR. JASON M ROSS D.C.
Practice Location Address:

1217 N. MONROE
GRAND RAPIDS, MI
49503

Practice Phone: 734-904-3609
Practice Fax:

1972945988 — DR. ERIC MICHAEL GRAF D.C.
Practice Location Address:

1217 MONROE AVE NW
GRAND RAPIDS, MI
49505-4619

Practice Phone: 616-451-6160
Practice Fax:

Directions to “ MR. TAD JACOBS DO” 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.