Individual
STEVE E JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
620 N MAIN ST, STE 101, BLACKSBURG, VA 24060-3385
(540) 953-0136
(540) 953-1358
Mailing address
620 N MAIN ST, STE 101, BLACKSBURG, VA 24060-3385
(540) 953-0136
(540) 953-1358
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000267
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009202609
—
VA
01
—
085491
BCBS
VA
01
—
410031149
RAILCAND MEDICARE
VA
Enumeration date
06/27/2005
Last updated
09/14/2011
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