| Roland W. Jacobs, Md, Pc | |
|
156 Cerrito-colorado Rd. Valdez NM 87580 | |
| (575) 770-7892 | |
| (575) 776-2922 |
| Full Name | Roland W. Jacobs, Md, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 156 Cerrito-colorado Rd., Valdez, New Mexico |
| Authorized Official Name and Position | Roland W. Jacobs (PRESIDENT) |
| Authorized Official Contact | 5757707892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roland W. Jacobs, Md, Pc Po Box 459 Arroyo Seco NM 87514-0459 Ph: (575) 770-7892 | Roland W. Jacobs, Md, Pc 156 Cerrito-colorado Rd. Valdez NM 87580 Ph: (575) 770-7892 |
| NPI Number | 1861401705 |
|---|---|
| Provider Enumeration Date | 08/07/2006 |
| Last Update Date | 02/18/2014 |
| Medicare PECOS PAC ID | 3072583079 |
|---|---|
| Medicare Enrollment ID | O20040728000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861401705 | NPI | - | NPPES |
| 80077226 | Medicaid | NM | |
| W18090 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 91225 (New Mexico) | Primary |
| Provider Name | Roland Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497762694 PECOS PAC ID: 7113997123 Enrollment ID: I20040804001273 |
Clearlight Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Gallo Pl, Valdez, NM 87580 Phone: 508-560-5630 |