Individual
MS. JODIE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
259 MAIN ST, YARMOUTH, ME 04096-6723
(207) 846-9013
(207) 523-8586
Mailing address
100 FODEN RD WEST, STE 203, SOUTH PORTLAND, ME 04106-2327
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA345
ME
Other
Enumeration date
03/17/2006
Last updated
11/18/2010
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