MEDICARE: CURTIS JACOBS

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	343900000X	Non-emergency Medical Transport (VAN)

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	:	1710429337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS JACOBS

Provider Business Mailing Address
First Line	:	60 KAUFFMANS CRK
Second Line	:
City	:	CLINTON
State	:	OH
Zip	:	44216-8658
Country	:	US
Telephone Number	:	330-352-4709
Fax Number	:

Provider Business Practice Location Address
First Line	:	2182 ROMIG RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-3879
Country	:	US
Telephone Number	:	330-785-3930
Fax Number	:	330-785-3934

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

Provider Enumeration Date	:	11/14/2016
Last Update Date	:	11/14/2016

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Directions to “ CURTIS JACOBS ” Practice Location

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