Provider Demographics
NPI:1003932955
Name:TOWNSEND, JACOB CROSS (MD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:CROSS
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PILOT MEDICAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3411
Mailing Address - Country:US
Mailing Address - Phone:205-856-2284
Mailing Address - Fax:205-815-4864
Practice Address - Street 1:100 PILOT MEDICAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3411
Practice Address - Country:US
Practice Address - Phone:205-856-2284
Practice Address - Fax:205-815-4777
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31145207RC0000X
AL27157207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL138950Medicaid
AL102I69760Medicare UPIN