Organization
JACOB GENERAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN ANDRE JACOB MD (OWNER)
(504) 264-9353
Entity
Organization
Contact information
Practice address
4228 HOUMA BLVD, SUITE 220, METAIRIE, LA 70006-3000
(504) 264-9353
(504) 301-9312
Mailing address
4228 HOUMA BLVD, SUITE 220, METAIRIE, LA 70006-3000
(504) 264-9353
(504) 301-9312
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
201551
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508535
—
LA
Enumeration date
11/14/2013
Last updated
11/14/2013
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