Individual
MICHAEL JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 LINN ST, ALLEGAN, MI 49010-1524
(616) 235-4800
Mailing address
5350 BECKLEY RD, SUITE C, BATTLE CREEK, MI 49015-4178
(269) 979-9400
(269) 979-2091
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301042676
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310A710590
BCBS PIN
—
05
—
4860083
—
MI
05
—
4860092
—
MI
01
—
DD4837
MEDICARE RR PIN
—
Enumeration date
05/26/2006
Last updated
09/20/2012
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