Individual
DR. RICHARD KEITH JACOB JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2151 W SPRING ST STE B210, MONROE, GA 30655
(770) 207-5738
(770) 266-7346
Mailing address
2151 W SPRING ST STE B210, MONROE, GA 30655-3214
(770) 207-5738
(770) 266-7346
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
58881
GA
Other
Enumeration date
03/19/2007
Last updated
03/19/2025
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