Individual
DR. STANLEY R. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 S 9TH ST, PHILADELPHIA, PA 19107-4408
(215) 955-1200
(215) 923-3729
Mailing address
25 S 9TH ST, 1ST FLOOR, PHILADELPHIA, PA 19107-4408
(215) 955-1200
(215) 923-6808
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD014283-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000759712
—
PA
05
—
2115603
—
NJ
Enumeration date
07/18/2006
Last updated
12/13/2013
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