Individual
KURT LEON JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
807 S ST RD 3, RUSHVILLE, IN 46173
(765) 933-1371
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331
(765) 827-7700
(765) 827-7796
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
990020099A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2073689
—
OH
Enumeration date
03/28/2006
Last updated
02/02/2012
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