Rouse, Jacob Dudley

Rouse, Jacob Dudley is an individual health care provider with primary practice located at 603 S Orange St , New Smyrna Beach FL 32168-7320. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Rouse, Jacob Dudley can be contacted via phone (386) 423-0333.

Contact Information

Primary practice address
603 S Orange St New Smyrna Beach FL 32168-7320
Phone: (386) 423-0333
Fax: (386) 423-0042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X ME32999 Florida

Profile Details

NPI number 1225013196
LBN Legal business name Rouse, Jacob Dudley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jul 14th, 2014 - about 12 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225013196 NPPES
Florida Other 4055589 AETNA
Florida Other 210925 AETNA
Florida Other 4703735004 AETNA
Florida Other AETNA AETNA
Florida MEDICAID 067960700 AETNA

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