Kevin Sean Jacob in Dry Ridge - Optometrist
Kevin Sean Jacob - NPI 1124173521
Kevin Sean Jacob is a Optometrist in Dry Ridge, Kentucky. Kevin Sean Jacob practices all healthcare services and medical treatments related to Optometrist. The NPI Number for Kevin Sean Jacob is 1124173521. The last update date is 2019-11-04.
Kevin Sean Jacob's current location address is 20 Ferguson Blvd, Dry Ridge, Kentucky. You can contact this provider via phone number 8598241333. The mailing address for Kevin Sean Jacob is 20 Ferguson Blvd, Dry Ridge, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Sean Jacob |
|---|---|
| Address | 20 Ferguson Blvd, Dry Ridge, Kentucky |
| Phone Number | 8598241333 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | O.D. |
NPI Number Detail
| NPI Number | 1124173521 |
|---|---|
| Provider Enumeration Date | 2007-01-24 |
| Last Updated Date | 2019-11-04 |
Provider Mailing Address Detail
| Address | 20 Ferguson Blvd |
|---|---|
| City | Dry Ridge |
| State | Kentucky (KY) |
| Post Code | 410358635 |
| Phone Number | 8598241333 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Optometrist |
|---|---|
| Taxonomy | 152W00000X |
| Licence No | 1458DT |
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Definition: Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 77001535 | KY | -- | |
| 1186679 | KY | CHA | |
| 255312 | KY | ANTHEM |
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What is the unique 10-digit identification code issued to Kevin Sean Jacob by the Centers for Medicare & Medicaid Services?
The Kevin Sean Jacob has been assigned the NPI (National Provider Identifier) 1124173521 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Kevin Sean Jacob?
The Kevin Sean Jacob is situated at 20 Ferguson Blvd, in the city of Dry Ridge, state of KY, with the zip code 410358635.
What is the Kevin Sean Jacob's specialty and taxonomy code?
The Kevin Sean Jacob's specialty is Optometrist, and the corresponding taxonomy code is 152W00000X.
When did Kevin Sean Jacob receive its 1124173521 assignment?
The Kevin Sean Jacob was assigned its 1124173521 on 2007-01-24, which is the date when this unique identifier was issued to the organization.
As of what date were the Kevin Sean Jacob's details last updated?
The information pertaining to the Kevin Sean Jacob, including its address, specialty, and other details, was most recently updated on 2019-11-04.