Jacobs Family Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

08646R Issued in LA

Legal business name

JACOBS FAMILY MEDICAL CLINIC

Practice address

102 E Fourth St
Dequincy, LA 70633-3502

Phone

(337) 786-3030

Fax

(337) 786-5066

NPI assigned

Apr 4, 2007

Last updated

Oct 19, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eric F Jacobs, M.D.NPI 1447379672

Title

Physician

Phone

(337) 786-3030

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric F Jacobs, M.D.

  • Family Medicine Physician
  • Dequincy, LA
  • NPI 1447379672
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1740302322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E FOURTH ST",
            "address_2": "PO BOX 1018",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333502",
            "telephone_number": "337-786-3030",
            "fax_number": "337-786-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E FOURTH ST",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333502",
            "telephone_number": "337-786-3030",
            "fax_number": "337-786-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOBS FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "337-786-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "08646R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1921718",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra H. Harville, LOT
• Nafeesa Hashmi, FNP
• Tayler Ryan Hext
• Imperial Health, LLP
• Imperial Health, LLP
• Eric F Jacobs, M.D.
• Jalal Joudeh (DeQuincy Medical Clinic)
• Charles James Johnson, RPH
• Jalal Joudeh, M.D.
• Lake Area Dentistry-Dequincy, LLC (Lake Area Dentistry)

• Family Medicine Physician in Dequincy, LA
• Providers in Dequincy, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.