Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2009010345 | MO |
NPI | 1215033840 |
---|---|
Provider Name | Dr. Zachary David Jacobs |
First Address | Kansas City, MO 64111-3315 |
Second Address | Kansas City, MO 64111-3315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 15/03/2021 |