Provider Demographics
NPI:1477042885
Name:EMBEE, JACOB ELI (DO)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:ELI
Last Name:EMBEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JACOB
Other - Middle Name:ELI
Other - Last Name:BADGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-0015
Mailing Address - Country:US
Mailing Address - Phone:609-412-5045
Mailing Address - Fax:
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-788-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MB11331200207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program