Organization
JACOBS FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC F JACOBS M.D. (PHYSICIAN)
(337) 786-3030
Entity
Organization
Contact information
Practice address
102 E FOURTH ST, DEQUINCY, LA 70633-3502
(337) 786-3030
(337) 786-5066
Mailing address
102 E FOURTH ST, PO BOX 1018, DEQUINCY, LA 70633-3502
(337) 786-3030
(337) 786-6066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08646R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1921718
—
LA
Enumeration date
04/04/2007
Last updated
10/19/2011
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