Individual
DR. KATHERINE ANNE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
37500 HARVEST AVE, AVON, OH 44011-2804
(216) 272-2663
Mailing address
5883 HICKORY TRL, N RIDGEVILLE, OH 44039-2650
(216) 272-2663
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
20150
WV
207W00000X
Ophthalmology Physician
Primary
35052754
OH
207W00000X
Ophthalmology Physician
MD017041
LA
207W00000X
Ophthalmology Physician
MD447449
PA
207W00000X
Ophthalmology Physician
ME60862
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0632088
—
OH
05
—
1027671530001
—
PA
01
—
107166
KAISER
OH
01
—
140766
ANTHEM PIN #
OH
01
—
E52754
SUMMA HEALTH CARE
OH
Enumeration date
05/26/2006
Last updated
12/31/2018
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