| Job Jacob MD PLLC | |
|
965 Carson Cv Ste A Conway AR 72034 | |
| (501) 513-2628 | |
| (501) 513-2630 |
| Full Name | Job Jacob MD PLLC |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 965 Carson Cv Ste A, Conway, Arkansas |
| Authorized Official Name and Position | Job Jacob (OWNER) |
| Authorized Official Contact | 5015132628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Job Jacob MD PLLC Po Box 10585 Conway AR 72034-0009 Ph: (501) 513-2628 | Job Jacob MD PLLC 965 Carson Cv Ste A Conway AR 72034 Ph: (501) 513-2628 |
| NPI Number | 1124152236 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124152236 | NPI | - | NPPES |
| 161356002 | Medicaid | AR | |
| MC-2479 | Other | AR | STATE LICENSE PLLC NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MC-2479 (Arkansas) | Primary |
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