National Provider Identifier

John Jacobs, PA

John Jacobs, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Horseheads, NY and a listed phone number of (607) 739-0352.

NPI 1871232793Horseheads, NYPhysician Assistant

Profile Overview

NPI
1871232793
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
May 31, 2022
Last Updated
March 15, 2024

Practice Location

  • 100 John Roemmelt Dr Ste 101
  • Horseheads, NY 14845-8302

Phone: (607) 739-0352

Mailing Address

  • 601 Elmwood Ave Box 670
  • Rochester, NY 14642-0001

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1871232793
Entity Type
Individual
Last Name
Jacobs
First Name
John
Credential
PA
Mailing Street Address
601 Elmwood Ave Box 670
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14642-0001
Mailing Country
US
Mailing Phone
(607) 301-4141
Practice Street Address
100 John Roemmelt Dr Ste 101
Practice City
Horseheads
Practice State
NY
Practice ZIP Code
14845-8302
Practice Country
US
Practice Phone
(607) 739-0352
Practice Fax
(607) 739-6909
Enumeration Date
May 31, 2022
Last Updated
March 15, 2024
Sex
Male
Sole Proprietor
No
Certification Date
March 15, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X)