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Individual

DR. GREGORY JACOB JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
728 W 11TH AVE, COVINGTON, LA 70433-2318
(985) 892-3766
Mailing address
PO BOX 669379, DALLAS, TX 75266-9379
(985) 892-3766

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
307297
LA
207R00000X
Internal Medicine Physician
307297
LA
207RP1001X
Pulmonary Disease Physician
Primary
307297
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2413163
LA
Enumeration date
03/23/2016
Last updated
04/29/2026
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