Individual
DR. JONATHAN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UT COLLEGE OF MEDICINE 920 MADISON AVE, SUITE C50, MEMPHIS, TN 38163-0001
(901) 448-5364
Mailing address
1875 VINTON AVE, MEMPHIS, TN 38104-5230
(901) 291-4900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45453
TN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/25/2007
Last updated
01/31/2017
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