Individual
RYAN CLINTON JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202-1702
(502) 240-8912
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(502) 240-8912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-5268
MS
Other
Enumeration date
04/19/2022
Last updated
07/16/2024
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