Individual
DR. RYAN ANDRE JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4228 HOUMA BLVD, SUITE 220, METAIRIE, LA 70006-3000
(504) 264-9353
(504) 301-9312
Mailing address
4228 HOUMA BLVD, SUITE 220, METAIRIE, LA 70006-3000
(504) 264-9353
(504) 301-9312
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.201551
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2160613
—
LA
Enumeration date
08/08/2007
Last updated
09/22/2011
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