Individual
SIDNEY M JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
950 PULASKI DR STE 100, KING OF PRUSSIA, PA 19406-2802
(610) 768-5940
(610) 768-5947
Mailing address
950 PULASKI DR STE 100, KING OF PRUSSIA, PA 19406-2802
(610) 768-5940
(610) 768-5947
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MA08447300
NJ
207X00000X
Orthopaedic Surgery Physician
MD427065
PA
207XS0106X
Orthopaedic Hand Surgery Physician
25MA084473000
NJ
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD427065
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106499
PENNSYLVANIA BLUE SHIELD
PA
01
—
3722652000
INDEPENDENCE BLUE CROSS - PERSONAL CHOICE
PA
Enumeration date
03/15/2007
Last updated
06/29/2020
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