Individual
DR. EDWARD T JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST
Contact information
Practice address
1 N MAYSVILLE ST, MOUNT STERLING, KY 40353-1315
(859) 498-6001
(859) 497-0222
Mailing address
1 N MAYSVILLE ST, MOUNT STERLING, KY 40353-1315
(859) 498-6001
(859) 497-0222
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1513DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382771
BCBS
KY
05
—
77000461
—
KY
Enumeration date
01/09/2007
Last updated
06/21/2013
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