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Individual

DR. JACOB JOHN WOLFRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4915 E BASELINE RD, GILBERT, AZ 85234-2965
(480) 812-3668
Mailing address
4915 E BASELINE RD, GILBERT, AZ 85234-2965
(480) 812-3668

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD-001046
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149399
AZ
Enumeration date
05/18/2018
Last updated
07/28/2025
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