Individual
DR. ROLAND W. JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 CERRITO-COLORADO RD., VALDEZ, NM 87580
(575) 770-7892
(575) 776-2922
Mailing address
PO BOX 1770, EL PRADO, NM 87529-1770
(575) 770-7892
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
91-225
NM
2084P0800X
Psychiatry Physician
G43460
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80077226
—
NM
05
—
8129228
—
CA
01
—
900521077
PROVIDER #
CA
01
—
WG43460B
INDIVIDUAL PTAN
CA
Enumeration date
08/01/2006
Last updated
08/20/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us