Individual
DR. BENJAMIN JOHNSON JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1875 COVE RD, VIRGINIA BEACH, VA 23459-8911
(757) 763-2060
Mailing address
2000 TRIDENT WAY, SAN DIEGO, CA 92155-5599
(619) 407-0214
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
0101270564
VA
Other
Enumeration date
04/08/2019
Last updated
09/30/2021
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