Provider Demographics
NPI:1467603670
Name:VELLA, JACOB ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:ANTHONY
Last Name:VELLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 241348
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-1348
Mailing Address - Country:US
Mailing Address - Phone:334-288-7808
Mailing Address - Fax:334-288-8089
Practice Address - Street 1:488 SAINT LUKES DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-288-7808
Practice Address - Fax:334-288-8089
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2019-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALMD.37307208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine