Mr Corey Jacobs, | |
712 Doctors Ct, Oshkosh, WI 54901-2029 | |
(920) 303-5300 | |
Not Available |
Full Name | Mr Corey Jacobs |
---|---|
Gender | Male |
Speciality | Occupational Therapist |
Location | 712 Doctors Ct, Oshkosh, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144834276 | NPI | - | NPPES |
100110834 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 6830-26 (Wisconsin) | Primary |
Provider Name | Aegis Group Practice Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1275073363 PECOS PAC ID: 5193036432 Enrollment ID: O20170614002978 |
Mailing Address | Practice Location Address |
---|---|
Mr Corey Jacobs, Po Box 735041, Chicago, IL 60673-5041 Ph: () - | Mr Corey Jacobs, 712 Doctors Ct, Oshkosh, WI 54901-2029 Ph: (920) 303-5300 |
Nicole Sophia Stevens, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3151 Eden Ct, Oshkosh, WI 54904 Phone: 920-651-4000 | |
Kimberly Mcguire, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 2700 W 9th Ave, Oshkosh, WI 54904 Phone: 920-236-1850 | |
Tyler Coenen, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 S Oakwood Rd, Oshkosh, WI 54904 Phone: 920-223-2000 | |
Emily Nault, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-456-7100 | |
Mrs. Jeanette Braun, OTR, CHT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-456-7100 Fax: 920-456-7123 | |
Anne Me Harrmann, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1130 N. Westfield St., Oshkosh, WI 54902 Phone: 920-237-2164 |