Individual
LEROY FRANK JACOBS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH, PHARM.D.
Contact information
Practice address
301 FISHER ST, PHARMACY, KEESLER AFB, MS 39534-2508
(228) 377-2086
Mailing address
301 FISHER ST, PHARMACY, KEESLER AFB, MS 39534-2508
(228) 377-2086
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15287
IA
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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