Dr. John Charles Pick-Jacobs
Family Doctor - Sports Medicine
7401 104th Ave Ste 110
Kenosha
, Wisconsin 53142
Dr. John Charles Pick-Jacobs
Family Doctor - Sports Medicine
7401 104th Ave Ste 110
Kenosha
, Wisconsin 53142
(262) 764-9314
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. John Charles Pick-Jacobs
- 7401 104th Ave Ste 110
- Kenosha, WI
- Zip : 53142-7845
- Fax : (262) 764-9314
- Phone : (262) 764-5595
Second Address
- Dr. John Charles Pick-Jacobs
- 7401 104th Ave Ste 110
- Kenosha, WI
- Zip : 53142
- Phone : (262) 764-5595
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 61756-21 | WI |
National Provider Identifier
| NPI | 1255607057 |
|---|---|
| Provider Name | Dr. John Charles Pick-Jacobs |
| First Address | Kenosha, WI 53142-7845 |
| Second Address | Kenosha, WI 53142 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/03/2012 |
| Last Update Date | 17/09/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.