Individual
DR. KENT F JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3610 SOUTHWIND RD, LAS CRUCES, NM 88007-5556
(575) 523-9095
(575) 523-0107
Mailing address
3610 SOUTHWIND RD, LAS CRUCES, NM 88007-5556
(575) 523-9095
(575) 523-0107
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
68-116
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13896
—
NM
Enumeration date
05/04/2009
Last updated
05/04/2009
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