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NPI Code Detail

MEDICARE: DR. JACOB THOMAS DEAN M.D.

MEDICARE: DR. JACOB THOMAS DEAN 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
1207Q00000XFamily Medicine Physician35081458OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932172467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB THOMAS DEAN M.D.
Provider Business Mailing Address
First Line : 7774 DAYTON SPRINGFIELD RD
Second Line :
City : FAIRBORN
State : OH
Zip : 45324-1957
Country : US
Telephone Number : 937-864-7363
Fax Number : 937-864-5895
Provider Business Practice Location Address
First Line : 7774 DAYTON SPRINGFIELD RD
Second Line :
City : FAIRBORN
State : OH
Zip : 45324-1957
Country : US
Telephone Number : 937-864-7363
Fax Number : 937-864-5895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 10/06/2025

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