Provider Demographics
NPI:1538301890
Name:TROUTMAN, JACOB ALAN (DO)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:ALAN
Last Name:TROUTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1210 S CEDAR CREST BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-402-1026
Practice Address - Fax:610-402-2499
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2019-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS0176482080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology