Individual
DR. JACOB BOCCUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912
(706) 721-2273
Mailing address
4234 WAYLON DR, MARTINEZ, GA 30907
(706) 402-5828
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15158
GA
Other
Enumeration date
06/26/2023
Last updated
06/27/2023
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