National Provider Identifier Database

JACOBS CLINIC INC
Family


Contact Information

JACOBS CLINIC, INC.
403 LISTER ST
A
WAYCROSS, GA31501-5225
Phone: 912-816-8956
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for JACOBS CLINIC, INC.

NPI Number 1033508791
Legal business name
LBN
JACOBS CLINIC, INC.
Authorized official ROBERT JACOBS - (NURSE PRACTITIONER/OWNER)
Entity Organization
Organization subpart No
Enumeration date 01/20/2015
Last updated 01/20/2015 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: RN121991NP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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