Individual
DR. PAUL CHRISTOPHER JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1001 N BEADLE DR, SUITE 40, CARBONDALE, IL 62901-1018
(618) 529-4817
(618) 351-9024
Mailing address
1001 N BEADLE DR, SUITE 40, CARBONDALE, IL 62901-1018
(618) 529-4817
(618) 351-9024
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
046007399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410002083
RAILROAD MEDICARE PTAN
—
01
—
410048999
RAILROAD MEDICARE PTAN
—
Enumeration date
09/13/2005
Last updated
08/09/2013
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