Individual
DR. BRADFORD JOEL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3319 W CHESTER PIKE, NEWTOWN SQUARE, PA 19073-4226
(610) 431-2971
(610) 356-2015
Mailing address
3319 W CHESTER PIKE, NEWTOWN SQUARE, PA 19073-4226
(610) 431-2971
(610) 356-2015
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC002599L
PA
213ES0131X
Foot Surgery Podiatrist
Primary
SC002599L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0909856
—
PA
Enumeration date
05/25/2006
Last updated
02/17/2020
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