Jacobs Family Medical Clinic | |
102 E Fourth St Dequincy LA 70633-3502 | |
(337) 786-3030 | |
(337) 786-5066 |
Full Name | Jacobs Family Medical Clinic |
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Speciality | Family Medicine |
Location | 102 E Fourth St, Dequincy, Louisiana |
Authorized Official Name and Position | Eric F Jacobs (PHYSICIAN) |
Authorized Official Contact | 3377863030 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jacobs Family Medical Clinic 102 E Fourth St Po Box 1018 Dequincy LA 70633-3502 Ph: (337) 786-3030 | Jacobs Family Medical Clinic 102 E Fourth St Dequincy LA 70633-3502 Ph: (337) 786-3030 |
NPI Number | 1740302322 |
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Provider Enumeration Date | 04/04/2007 |
Last Update Date | 10/19/2011 |
Medicare PECOS PAC ID | 5890894828 |
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Medicare Enrollment ID | O20070615000438 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740302322 | NPI | - | NPPES |
1921718 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 08646R (Louisiana) | Primary |
Provider Name | Eric F Jacobs |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447379672 PECOS PAC ID: 2062511090 Enrollment ID: I20070802000189 |
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