Provider Demographics
NPI:1801387873
Name:NOVECK, JACOB J (MD)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:J
Last Name:NOVECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:222 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-5865
Mailing Address - Country:US
Mailing Address - Phone:248-798-0640
Mailing Address - Fax:
Practice Address - Street 1:11075 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5000
Practice Address - Country:US
Practice Address - Phone:352-691-5250
Practice Address - Fax:352-691-5252
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301504877207R00000X
FLME157041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine