Individual
GENEVIEVE CAMILLA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04488
KY
207R00000X
Internal Medicine Physician
R4099
KY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
04488
KY
208100000X
Physical Medicine & Rehabilitation Physician
131835
MT
Other
Enumeration date
03/28/2016
Last updated
05/17/2024
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