Individual
DR. LOUIS ISRAEL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6255 INKSTER RD, SUITE #206, GARDEN CITY, MI 48135-2577
(734) 421-0044
(734) 458-3364
Mailing address
18181 OAKWOOD BLVD 403, DEARBORN, MI 48124-3960
(313) 982-5290
(313) 982-5295
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
LJ006797
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1367083
—
MI
01
—
5821167
BCBSM
MI
Enumeration date
07/20/2005
Last updated
12/03/2015
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