Individual
DR. JOHN BENJAMIN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9755 W STATE HIGHWAY 22, RATCLIFF, AR 72951-9000
(479) 635-5300
(479) 635-2010
Mailing address
9755 W STATE HIGHWAY 22, RATCLIFF, AR 72951-9000
(479) 635-5300
(479) 635-2010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C7933
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062731
UMWA H&R FUNDS
AR
01
—
020407900
BLACK LUNG PROGRAM
AR
01
—
0790780001
PALMETTO GBA
AR
01
—
080046831
RAILROAD MEDICARE/PALMETT
AR
05
—
123744001
—
AR
01
—
15346000000
QUALCHOICE
AR
01
—
1670799
UNITED HEALTHCARE
AR
01
—
375018
HEALTH LINK
AR
01
—
55027
BLUECROSSBLUESHIELD ARK
AR
01
—
7959093
AETNA INSURANCE COMPANY
AR
01
—
XX12984
HEALTH PLUS OF MICHIGAN
AR
Enumeration date
01/26/2006
Last updated
07/22/2014
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