Jacobs, Mary Amanda
Jacobs, Mary Amanda is an individual health care provider with primary practice located at 2188 Sandy Dr , State College PA 16803-2288. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is her primary health care specialty. Jacobs, Mary Amanda can be contacted via phone (814) 237-6600.Contact Information
Primary practice address
2188 Sandy Dr
State College PA 16803-2288
Phone: (814) 237-6600
Fax: (814) 237-5383
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 46763 | Minnesota |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | MD437386 | Pennsylvania |
Profile Details
| NPI number | 1811973894 |
|---|---|
| LBN Legal business name | Jacobs, Mary Amanda |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2005 |
| Last updated | Aug 21st, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811973894 | NPPES |
| Iowa | MEDICAID | ENROLLED | |
| Iowa | MEDICAID | 102337081 | |
| Iowa | MEDICAID | 699485700 | |
| Iowa | Other | P00333407 | |
| Iowa | MEDICAID | 35163500 |
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