Individual
JACOB C JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 562-2211
Mailing address
10840 VOSIKOF PL, ANCHORAGE, AK 99507-6461
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD60946865
WA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
212001
AK
2080P0210X
Pediatric Nephrology Physician
212001
AK
Other
Enumeration date
06/02/2013
Last updated
04/02/2024
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