Individual
DR. COURTNEY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
864 S CLEARVIEW PKWY, APT 136, RIVER RIDGE, LA 70123-6323
(781) 696-2530
Mailing address
864 S CLEARVIEW PKWY, APT 136, RIVER RIDGE, LA 70123-6323
(781) 696-2530
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101267326
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
0101267326
VA
Other
Enumeration date
03/22/2016
Last updated
05/21/2021
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