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Individual

DR. EUGENE GARDNER JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5400-10 WISSAHICKON AVE., PHILADELPHIA, PA 19144-5225
(215) 842-1443
(215) 842-0571
Mailing address
5400 - 10 WISSAHICKON AVE, PHILADELPHIA, PA 19144-5225
(215) 842-1443
(215) 842-0571

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
023916-L
PA

Other

Enumeration date
05/09/2007
Last updated
07/08/2007
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