Sup, Jacob

Sup, Jacob is an individual health care provider with primary practice located at 2005 Arlington Ave , Caldwell ID 83605-4808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sup, Jacob can be contacted via phone (208) 459-1025.

Contact Information

Primary practice address
2005 Arlington Ave Caldwell ID 83605-4808
Phone: (208) 459-1025
Fax: (208) 459-1080
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X O-1402 Idaho

Profile Details

NPI number 1295266401
LBN Legal business name Sup, Jacob
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2017
Last updated Aug 7th, 2020 - about 6 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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