Individual
BRIAN S JACOBS
Active
Individual
BRIAN S JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
47004
MN
207Q00000X
Family Medicine Physician
OS014838
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
OS014838
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102381212
—
PA
05
—
670998200
—
MN
Enumeration date
01/03/2006
Last updated
08/05/2020
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