Provider Demographics
NPI:1346480308
Name:JACOBS, JAMES RALPH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RALPH
Last Name:JACOBS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 MILLIKIN RD
Mailing Address - Street 2:OSU STUDENT HEALTH SERVICES
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-2200
Mailing Address - Country:US
Mailing Address - Phone:614-743-9629
Mailing Address - Fax:614-247-6074
Practice Address - Street 1:1875 MILLIKIN RD
Practice Address - Street 2:OSU STUDENT HEALTH SERVICES
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-2200
Practice Address - Country:US
Practice Address - Phone:614-743-9629
Practice Address - Fax:614-247-6074
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH094686207P00000X
NY230097207P00000X
NC96-01157207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine