Provider Demographics
NPI:1205001385
Name:JACOBS, FRED MARTIN (MD JD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:MARTIN
Last Name:JACOBS
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Gender:M
Credentials:MD JD
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Mailing Address - Street 1:95 OLD SHORT HILLS RD
Mailing Address - Street 2:SAINT BARNABAS HEALTH CARE SYSTEM
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052
Mailing Address - Country:US
Mailing Address - Phone:973-322-4011
Mailing Address - Fax:973-322-4074
Practice Address - Street 1:95 OLD SHORT HILLS RD
Practice Address - Street 2:SAINT BARNABAS HEALTH CARE SYSTEM
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-322-4011
Practice Address - Fax:973-322-4074
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02025900207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease