Dr. Kevin Jacobs O.D.
Optometrist in East Lansing, MI(View on Map)
Full Name
Dr. Kevin Jacobs O.D.
NPI Number
1801840657
NPI Type
Individual Provider
Gender
Male
Enumeration Date
05/19/2006
Specialties
(Taxonomies)Name
Code
152W00000X
152WC0802X
152WP0200X
152WV0400X
Primary Taxonomy
Yes
No
No
No
Licenses
State
Michigan
License Number
4901004013
Contact
Information
Purpose
Mailing
Location
Address
1905 ABBOT RD STE 1
1905 ABBOT RD STE 1
City
East Lansing
East Lansing
State
MI
MI
Postal Code
48823-8571
48823-8571
Country
US
US
Telephone Number
(517) 580-8733
(517) 580-8733
Identifiers
Identifier
22-70122
86-4792288
22-00122
900C313100
1019456
94-4318770
Identifier State
MI
MI
MI
MI
MI
MI
Identifier Issuer
PHP-MEDICAID
Unknown
PHYSICANS HEALTH PLAN-PHP
BCBS
MCLAREN
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/12/2021
Provider Address
Other Optometrists in East Lansing, Michigan:
Cheryl Vincent-riemer OD
East Lansing, MISpecialties: Optometrist (Primary)Corneal and Contact Management Optometrist