Individual
KRISTEN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 234-4176
Mailing address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 234-4176
(574) 234-1561
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01037063
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301055183
MI
Other
Enumeration date
09/28/2006
Last updated
01/05/2024
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