Individual
DR. JACOB MICHAEL FEAGANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23 MACK BAYOU LOOP, SANTA ROSA BEACH, FL 32459-2606
(850) 390-4540
(850) 390-4540
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
(850) 390-4540
(850) 390-4540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.201317
LA
207RG0100X
Gastroenterology Physician
21382
MS
207RG0100X
Gastroenterology Physician
Primary
ME153671
FL
207RG0100X
Gastroenterology Physician
TRN13023
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113815400
—
FL
01
—
15513591
CAQH
—
Enumeration date
11/10/2007
Last updated
07/01/2022
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