Individual
JOHN JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(734) 560-6224
Mailing address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-6019
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
4301110446
MI
Other
Enumeration date
06/15/2016
Last updated
08/11/2022
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