Individual
JOHN WILLIAM JACOBS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME120457
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012995900
—
FL
01
—
14VK0
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/03/2008
Last updated
03/30/2021
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