# JACOB GERALD GROSS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1356086508
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | POD2025-0001 | NM | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC007300 | PA | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | PA | — |

## Other

- **Enumeration date:** 05/02/2022
- **Last updated:** 06/22/2025