Individual
MR. JACOB BIGELOW GORSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0935
(602) 933-2471
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9775
AZ
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137395
—
AZ
Enumeration date
06/01/2023
Last updated
06/19/2024
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