Provider Demographics
NPI:1346208824
Name:JACOBUS, CHRISTIAN HOHENLOHE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:HOHENLOHE
Last Name:JACOBUS
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 1:15100 BIRCHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9773
Mailing Address - Country:US
Mailing Address - Phone:419-423-5351
Mailing Address - Fax:419-423-8967
Practice Address - Street 1:15100 BIRCHAVEN LN
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9773
Practice Address - Country:US
Practice Address - Phone:419-423-5351
Practice Address - Fax:419-423-8967
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085523207P00000X
MI4301097517207P00000X
OH35.085523207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2637310Medicaid
OH2637310Medicaid
JA4178911Medicare ID - Type Unspecified