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Individual

CHARLES N JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 872-1293
(207) 872-1091
Mailing address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 872-1293
(207) 872-1091

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
013355
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
243660099
ME
Enumeration date
02/23/2006
Last updated
10/16/2012
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