Individual
DR. JACOB E. ULMER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 HWY 19 N, MERIDIAN, MS 39307-5335
(601) 483-5353
(601) 482-1753
Mailing address
PO BOX 5166, MERIDIAN, MS 39302-5166
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10071
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114181
—
MS
05
—
009815300
—
AL
01
—
080050994
RAILROAD MEDICARE
—
01
—
730-70963
BLUE CROSS OF AL
—
Enumeration date
11/18/2005
Last updated
11/06/2013
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