Individual
DR. TOMAS HUMBERTO JACOME JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7777 HENNESSY BLVD STE 102, BATON ROUGE, LA 70808-4363
(225) 765-2048
(225) 765-1958
Mailing address
7777 HENNESSY BLVD STE 102, BATON ROUGE, LA 70808-4363
(225) 765-2048
(225) 765-1958
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
025420
LA
2086S0102X
Surgical Critical Care Physician
025420
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09102317
—
MS
05
—
1575674
—
LA
01
—
363070
WELLCARE
—
Enumeration date
08/03/2005
Last updated
03/26/2021
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