Individual
MR. POTHEN JACOB
Active
Individual
MR. POTHEN JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME55603
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01990
WELLCARE
—
05
—
055528200
—
FL
01
—
08999
BCBS FLORIDA
—
01
—
100013671
RAILROAD MEDICARE
—
01
—
1035494
CAREPLUS
—
01
—
10694801
CITRUS HEALTHCARE
—
01
—
1200283-007
CIGNA
—
01
—
206516
AV MED
—
01
—
225659
AMERIGROUP
—
01
—
2905049
UNITED HEALTHCARE
—
01
—
4248344
AETNA
—
01
—
9630253
GHI
—
Enumeration date
01/31/2006
Last updated
10/05/2020
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