Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD462626 | PA |
NPI | 1134105323 |
---|---|
Provider Name | Dr. Bryon N Jacoby |
First Address | Lancaster, PA 17601-2433 |
Second Address | Lancaster, PA 17601-2433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 10/11/2017 |