Organization
MARY ANN JACOB, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN JACOB M.D. (MEMBER/MANAGER)
(907) 274-0274
Entity
Organization
Contact information
Practice address
2841 DEBARR RD, SUITE 45, ANCHORAGE, AK 99508-2958
(907) 274-0274
Mailing address
2841 DEBARR RD, SUITE 45, ANCHORAGE, AK 99508-2958
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
128883
AK
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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