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Individual

DR. LAWRENCE J JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9500 EUCLID AVE, WL20, CLEVELAND, OH 44195-0001
(440) 899-5555
Mailing address
9500 EUCLID AVE, WL20, CLEVELAND, OH 44195-0001
(440) 899-5555

Taxonomy

Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35060098J
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060016720
RAILROAD MEDICARE
OH
05
0872926
OH
Enumeration date
09/12/2005
Last updated
11/25/2011
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