Tom, Jacob Joseph

Tom, Jacob Joseph is an individual health care provider with primary practice located at 960 N 16Th St Ste 103 , Springfield OR 97477-4175. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Tom, Jacob Joseph can be contacted via phone (541) 726-4694.

Contact Information

Primary practice address
960 N 16Th St Ste 103 Springfield OR 97477-4175
Phone: (541) 726-4694
Fax: (541) 744-6069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 39631 Washington

Profile Details

NPI number 1912972258
LBN Legal business name Tom, Jacob Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Jun 8th, 2011 - about 15 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 1912972258 NPPES
Oregon MEDICAID 287539

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