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Individual

JONATHAN T. JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5701 W 119TH ST STE 419, OVERLAND PARK, KS 66209-3721
(913) 498-1444
(913) 667-2759
Mailing address
5701 W 119TH ST STE 419, OVERLAND PARK, KS 66209-3721
(913) 498-1444
(913) 667-2759

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-29916
KS
207R00000X
Internal Medicine Physician
Primary
0429916
KS
207R00000X
Internal Medicine Physician
2002028986
MO
208000000X
Pediatrics Physician
04-29916
KS
208000000X
Pediatrics Physician
2002028986
MO
208M00000X
Hospitalist Physician
0429916
KS
208M00000X
Hospitalist Physician
2002028986
MO

Other

Enumeration date
06/23/2006
Last updated
10/26/2017
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