Organization
PROFESSIONAL PSYCHIATRIC ASSOCIATES & CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS G JACOBS M.D. (PRESIDENT)
(781) 591-5221
Entity
Organization
Contact information
Practice address
16 MICA LN STE 101, WELLESLEY HILLS, MA 02481-1721
(781) 591-5221
(781) 235-6390
Mailing address
33 LILLIAN WAY, WAYLAND, MA 01778-3030
(781) 591-5221
(781) 235-6390
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34367
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M1439301
MEDICARE GROUP PTAN
MA
Enumeration date
02/07/2008
Last updated
11/16/2023
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