Individual
MATT B JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5155 E. EAGLE DRIVE #20730, MESA, AZ 85277-3031
(480) 706-9430
(480) 378-2273
Mailing address
5155 E. EAGLE DRIVE #20730, MESA, AZ 85277-3031
(480) 706-9430
(480) 378-2273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5936
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
981219
—
AZ
01
—
P01499301
RAILROAD MEDICARE
AZ
Enumeration date
11/24/2014
Last updated
04/08/2025
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