Taber, Jacob Edward
Taber, Jacob Edward is an individual health care provider with primary practice located at 740 Reena Ave , Fort Atkinson WI 53538-3145. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Taber, Jacob Edward can be contacted via phone (920) 563-0888.Contact Information
Primary practice address
740 Reena Ave
Fort Atkinson WI 53538-3145
Phone: (920) 563-0888
Fax: (920) 568-3516
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 81240-21 | Wisconsin |
Profile Details
| NPI number | 1235711573 |
|---|---|
| LBN Legal business name | Taber, Jacob Edward |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2021 |
| Last updated | Aug 13th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235711573 | NPPES |
| Wisconsin | MEDICAID | 1235711573 |
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