Individual
MICHAEL SCOTT JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1080 VEND DR, SUITE 100, WATKINSVILLE, GA 30677-7751
(706) 549-7047
(706) 613-5395
Mailing address
1080 VEND DR STE 100, WATKINSVILLE, GA 30677-7751
(706) 549-7047
(706) 613-5395
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
053926
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220660534
—
GA
01
—
P00131029
RAILROAD RETIREMENT
GA
Enumeration date
02/07/2006
Last updated
11/04/2015
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