# JACOBS FAMILY MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740302322
- **Authorized official:** DR. ERIC F JACOBS M.D. (PHYSICIAN)
- **Authorized official phone:** (337) 786-3030

## Contact information

- **Practice address:** 102 E FOURTH ST, DEQUINCY, LA 70633-3502
- **Practice address phone:** (337) 786-3030
- **Practice address fax:** (337) 786-5066
- **Mailing address:** 102 E FOURTH ST, PO BOX 1018, DEQUINCY, LA 70633-3502
- **Mailing address phone:** (337) 786-3030
- **Mailing address fax:** (337) 786-6066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 08646R | LA | Yes |

## Other

- **Enumeration date:** 04/04/2007
- **Last updated:** 10/19/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1921718 | — | LA |