Individual
DR. JACOB ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5282 MEDICAL DR, SAN ANTONIO, TX 78229-4849
(210) 450-9850
Mailing address
4801 E LINWOOD BLVD, KANSAS CITY, MO 64128-2226
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
R1203
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2013
Last updated
01/15/2020
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