Individual
BRADLEY G JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7170 HIGHWAY 278, STE B, COVINGTON, GA 30014
(770) 787-6200
(770) 787-2643
Mailing address
7170 HIGHWAY 278, SUITE B, COVINGTON, GA 30014
(770) 787-6200
(770) 787-2643
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
027835
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000326697B
—
GA
Enumeration date
10/19/2006
Last updated
08/02/2012
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