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NPI Code Detail

MEDICARE: DR. LAURA JACOBS

MEDICARE: DR. LAURA 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
1225100000XPhysical Therapist30758MD

General Provider Information

NPI Number : 1992658488
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA JACOBS
Provider Business Mailing Address
First Line : 21395 FAIRWOOD CT
Second Line :
City : LEONARDTOWN
State : MD
Zip : 20650-6128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23000 MOAKLEY ST STE 101
Second Line :
City : LEONARDTOWN
State : MD
Zip : 20650-2916
Country : US
Telephone Number : 301-475-5830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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