Individual
JERRY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST STE E, PHILADELPHIA, PA 19104-4223
(215) 662-4000
Mailing address
3400 SPRUCE ST, 3 SILVERSTEIN, STE E, PHILADELPHIA, PA 19104-4206
(215) 662-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD442424
PA
207RI0200X
Infectious Disease Physician
Primary
MD442424
PA
Other
Enumeration date
06/27/2008
Last updated
12/06/2017
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