Individual
DOUGLAS SCOTT JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 N 39TH ST, 4 HVP, PHILADELPHIA, PA 19104-2640
(215) 662-9189
Mailing address
51 N 39TH ST, 4 HVP, PHILADELPHIA, PA 19104-2640
(215) 662-9189
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD417626
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014170250003
—
PA
Enumeration date
06/27/2006
Last updated
08/18/2015
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