Individual
DR. JOSEPH P JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2695 ROCKY MOUNTAIN AVE, SUITE 200, LOVELAND, CO 80538-8702
(970) 495-8490
(970) 484-5682
Mailing address
2695 ROCKY MOUNTAIN AVE, SUITE 200, LOVELAND, CO 80538-8702
(970) 495-8490
(970) 484-5682
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
DR.0043793
CO
208100000X
Physical Medicine & Rehabilitation Physician
Primary
43793
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123553200
—
WY
05
—
19835027
—
CO
01
—
P00311590
RAILROAD MEDICARE
—
Enumeration date
05/22/2006
Last updated
03/23/2016
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