Individual
EAPEN K JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
41642
MN
207ZC0500X
Cytopathology Physician
41642
MN
207ZP0101X
Anatomic Pathology Physician
41642
MN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
41642
MN
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
41642
MN
Other
Enumeration date
12/19/2005
Last updated
10/06/2020
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