Individual
LEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 POST RD STE L1, SOUTHPORT, CT 06890-1258
(203) 254-3886
(203) 254-3872
Mailing address
SOUTHPORT WOMEN'S HEALTHCARE, 2600 POST ROAD, SUITE L1, SOUTHPORT, CT 06890
(203) 254-3886
(203) 254-3872
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
041183
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001411834
—
CT
Enumeration date
07/20/2006
Last updated
07/21/2022
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