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Individual

DR. THOMAS P JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2489 DIPLOMAT PKWY E, CAPE CORAL, FL 33909-5422
(239) 652-1800
Mailing address
2248 EPHRAIM AVE, FORT MYERS, FL 33907-4221

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME99302
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/21/2007
Last updated
07/06/2015
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