Individual
JACOB MANALOOR ABRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 DOCTORS DR STE K, DOUGLAS, GA 31533-2202
(912) 384-4024
Mailing address
PO BOX 1377, DOUGLAS, GA 31534-1377
(912) 384-1477
(912) 384-1470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
085757
GA
390200000X
Student in an Organized Health Care Education/Training Program
5101023560
MI
Other
Enumeration date
06/24/2017
Last updated
02/06/2025
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