Provider Demographics
NPI:1437540796
Name:SAKIEY, JACOB R (PA)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:R
Last Name:SAKIEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 LAMB CIR
Mailing Address - Street 2:SUITE L-760
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6344
Mailing Address - Country:US
Mailing Address - Phone:540-731-2436
Mailing Address - Fax:540-731-2439
Practice Address - Street 1:100 KNOTBREAK RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-5414
Practice Address - Country:US
Practice Address - Phone:540-444-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110004829363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437540796OtherUMWA
VA1437540796OtherOPTIMA HEALTH PLAN
VA1437540796OtherAETNA
VA1437540796OtherHUMANA MEDICARE
VA1437540796OtherTRICARE
VA1437540796OtherMEDICAID QMB
VA1437540796OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1437540796OtherINTOTAL
VA1437540796OtherANTHEM MEDIGAP
VA1437540796OtherCCC VIRGINIA PREMIER
VAP01520561OtherRAILROAD MEDICARE
VA1437540796OtherAETNA