Individual
ROSS LANG JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 297-2200
(770) 534-8139
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
057204
GA
207VG0400X
Gynecology Physician
Primary
057204
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0677272
UNITED HEALTHCARE
GA
01
—
10038639
AMERIGROUP
GA
05
—
238806338A
—
GA
05
—
238806338B
—
GA
05
—
238806338C
—
GA
05
—
238806338D
—
GA
05
—
238806338E
—
GA
01
—
340853
WELLCARE
GA
01
—
4069685
AETNA
GA
01
—
4346566
CIGNA
GA
01
—
52197850
BCBS
GA
Enumeration date
01/18/2006
Last updated
08/14/2019
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