Individual
JEFFRY ALAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
3608 FARAON ST, SAINT JOSEPH, MO 64506-3044
(816) 232-4417
Mailing address
12932 ORCHARD CROSSING LN, KNOXVILLE, TN 37934-1222
(865) 202-2209
(865) 321-8900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35908KY
KY
2084P0800X
Psychiatry Physician
MD38701
TN
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2022007260
MO
2084P0804X
Child & Adolescent Psychiatry Physician
MD60579729
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108213
—
MO
Enumeration date
04/19/2006
Last updated
07/25/2024
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