Individual
DR. MARK EDWARD JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
300 JULIAN LN, ARDEN, NC 28704-7809
(828) 650-2727
(828) 650-2725
Mailing address
507 GREENVILLE BLVD SE, GREENVILLE, NC 27858-6756
(252) 558-0289
(252) 439-0000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC 1366
NC
152W00000X
Optometrist
NY 005118
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0908J
BCBS
NC
05
—
890908J
—
NC
Enumeration date
06/09/2006
Last updated
12/11/2020
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