Organization
RICHARD P JACOBY DPM, PC
Active
Other names
Extremity Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD PAUL JACOBY DPM (OWNER)
(480) 994-5977
Entity
Organization
Contact information
Practice address
9475 E IRONWOOD SQUARE DR STE 100, SCOTTSDALE, AZ 85258-4576
(480) 994-5977
(480) 990-9397
Mailing address
4747 N SCOTTSDALE RD STE C4005, SCOTTSDALE, AZ 85251-7666
(480) 994-5977
(480) 672-2288
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00084
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189007100
DEPT OF LABOR
AZ
01
—
1Z1219
HEALTHNET PIN
AZ
01
—
2572688
AETNA PIN
AZ
05
—
700626
—
AZ
01
—
AZ0190960
BCBSAZ PIN
AZ
01
—
DA8041
RR MEDICARE PIN
AZ
Enumeration date
12/28/2005
Last updated
04/20/2023
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