Organization
R. DANIEL JACOB, M.D.,A.P.M.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUDOLPH DANIEL JACOB M.D. (PRESIDENT)
(504) 454-3611
Entity
Organization
Contact information
Practice address
4228 HOUMA BLVD, SUITE 340, METAIRIE, LA 70006-3000
(504) 454-3611
(504) 888-9452
Mailing address
351 VINCENT AVE, METAIRIE, LA 70005-4419
(504) 454-3611
(504) 888-9452
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD.012606
LA
207YP0228X
Pediatric Otolaryngology Physician
MD.012606
LA
207YS0012X
Sleep Medicine (Otolaryngology) Physician
MD.012606
LA
207YS0123X
Facial Plastic Surgery Physician
MD.012606
LA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
MD.012606
LA
207YX0602X
Otolaryngic Allergy Physician
MD.012606
LA
207YX0901X
Otology & Neurotology Physician
MD.012606
LA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD.012606
LA
Other
Enumeration date
09/17/2008
Last updated
01/27/2009
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