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Individual

JACOB METCALF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
400 BURT DR APT C37, DOTHAN, AL 36305-1121
(334) 596-2129
Mailing address
400 BURT DR APT C37, DOTHAN, AL 36305-1121
(334) 596-2129

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
143394
AL
390200000X
Student in an Organized Health Care Education/Training Program
AL

Other

Enumeration date
06/28/2021
Last updated
05/22/2023
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