Individual
MARK JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 WEST CHESTER PIKE, SUITE #202, HAVERTOWN, PA 19083-3442
(610) 789-3510
(610) 789-3591
Mailing address
1010 WEST CHESTER PIKE, SUITE #202, HAVERTOWN, PA 19083-3442
(610) 789-3510
(610) 789-3591
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD020668E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078331502
—
PA
Enumeration date
06/24/2006
Last updated
02/20/2015
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