Individual
DR. MARK D. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 2ND AVE, NEEDHAM, MA 02494-2809
(781) 726-4800
Mailing address
100 2ND AVE, NEEDHAM, MA 02494-2809
(781) 726-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
242029
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
242029
MEDICAL LICENSE
MA
01
—
404478
TUFTS HEALTH PLAN
MA
01
—
9239986
CIGNA
MA
01
—
9971374
AETNA
MA
01
—
AA173484
HPHC
MA
01
—
NPI
1124013883
MA
Enumeration date
09/19/2005
Last updated
12/19/2016
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