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Individual

JACOB WILLIAM FISHBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3537 W FRONT ST STE A, TRAVERSE CITY, MI 49684-7942
(231) 935-0338
(231) 935-0569
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2386
(231) 392-0773
(231) 935-5885

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10434
GA

Other

Enumeration date
06/04/2021
Last updated
08/06/2025
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