Glen C Jacob
Surgeon Surgery of the Hand and 1 more
1175 East Mountain Blvd.
Wilkes-Barre
, Pennsylvania 18702-3885
Glen C Jacob
Surgeon Surgery of the Hand and 1 more
1175 East Mountain Blvd.
Wilkes-Barre
, Pennsylvania 18702-3885
(570) 271-6144
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About
Features
Specialties
- Surgeon
- Surgery of the Hand
Languages spoken
- English
Location
First Address
- Glen C Jacob
- 100 N Academy Ave
- Danville, PA
- Zip : 17822-4903
- Phone : (570) 271-6144
Second Address
- Glen C Jacob
- 1175 East Mountain Blvd.
- Wilkes-Barre, PA
- Zip : 18702-3885
- Fax : (570) 808-7878
- Phone : (570) 808-1093
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | MD452555 | PA |
| N | 208600000X | Surgeon | MD452555 | PA |
| N | 208200000X | Surgeon | N0127 | TX |
| N | 208600000X | Surgeon | N0127 | TX |
| N | 2086S0105X | Surgery of the Hand | 24108 | WV |
| N | 2086S0105X | Surgery of the Hand | 25MA08617700 | NJ |
| Y | 2086S0105X | Surgery of the Hand | MD452555V | PA |
National Provider Identifier
| NPI | 1295990976 |
|---|---|
| Provider Name | Glen C Jacob |
| First Address | Danville, PA 17822-4903 |
| Second Address | Wilkes-Barre, PA 18702-3885 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/07/2008 |
| Last Update Date | 11/08/2020 |
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.