Individual
JACOB HEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1113 S STATE ST STE 202, DOVER, DE 19901-4112
(302) 261-5600
(302) 450-3181
Mailing address
1113 S STATE ST STE 202, DOVER, DE 19901-4112
(302) 261-5600
(302) 450-3181
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C50011629
DE PROFESSIONAL LICENSE
DE
Enumeration date
11/08/2021
Last updated
08/14/2023
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