Individual
MR. DONALD RICHARD JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6075 SO QUEBEC, STE 203, CENTENNIAL, CO 80111
(303) 796-9232
(303) 796-0324
Mailing address
6087 S QUEBEC ST, STE 103, CENTENNIAL, CO 80111-4540
(303) 796-9232
(303) 796-0324
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
CO21736
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01217363
—
CO
Enumeration date
11/29/2006
Last updated
04/25/2016
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