Individual
COREY DUANE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 W 1ST ST STE 101, ELK CITY, OK 73644-3133
(580) 225-2516
(580) 303-5830
Mailing address
1800 W 1ST ST STE 101, ELK CITY, OK 73644-3133
(580) 225-2516
(580) 303-5830
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
27305
AL
207V00000X
Obstetrics & Gynecology Physician
Primary
M-15890
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009938418
—
AL
01
—
20022468
MEDICARE
ID
01
—
51539428
BC AL
AL
01
—
7S5816
MEDICARE
OK
05
—
808198200
—
ID
Enumeration date
07/12/2006
Last updated
09/05/2025
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