Individual
KYLE AUSTIN JAKOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16777 MEDICAL CENTER DR, BATON ROUGE, LA 70816-3254
(225) 761-5200
(225) 754-3265
Mailing address
1514 JEFFERSON HWY, BH 634, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.206091
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01954729
—
MS
05
—
2148427
—
LA
05
—
INTERN
—
LA
Enumeration date
06/10/2011
Last updated
10/20/2016
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