Individual
DR. DIANE JEAN JACOBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
809 MEDICAL PARK DR, SUITE 101, MEXICO, MO 65265
(573) 581-8590
(573) 473-3706
Mailing address
809 MEDICAL PARK DR, SUITE 101, MEXICO, MO 65265-3753
(573) 581-8590
(573) 473-3706
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
113579
MO
207Q00000X
Family Medicine Physician
Primary
113579
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209683002
—
MO
Enumeration date
12/15/2005
Last updated
06/28/2022
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