Individual
DR. RUDOLPH DANIEL JACOB
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4228 HOUMA BLVD, SUITE 340, METAIRIE, LA 70006-3000
(504) 454-3611
(504) 888-9452
Mailing address
4228 HOUMA BLVD, SUITE 340, METAIRIE, LA 70006-3000
(504) 454-3611
(504) 888-9452
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
012606
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1347159
—
LA
Enumeration date
01/25/2006
Last updated
07/08/2007
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