Provider Demographics
NPI:1619137924
Name:JACOB M. ESTES, M.D., LLC
Entity Type:Organization
Organization Name:JACOB M. ESTES, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GYN ONCOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-216-3006
Mailing Address - Street 1:9000 AIRLINE HWY
Mailing Address - Street 2:STE 210
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4114
Mailing Address - Country:US
Mailing Address - Phone:225-216-3006
Mailing Address - Fax:
Practice Address - Street 1:9000 AIRLINE HWY
Practice Address - Street 2:STE 210
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4114
Practice Address - Country:US
Practice Address - Phone:225-216-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1184349Medicaid
1255381687OtherNPPES
1255381687OtherNPPES