Individual
DR. EACHARANGAD IPYE JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
629 E HIGHWAY 98, PANAMA CITY, FL 32401-3611
(850) 914-9119
(850) 913-1670
Mailing address
629 E HIGHWAY 98, PANAMA CITY, FL 32401-3611
(850) 914-9119
(850) 913-1670
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
ME0054778
FL
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
ME0054778
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035463500
—
FL
Enumeration date
06/30/2006
Last updated
07/30/2012
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