Provider Demographics
NPI:1205903283
Name:JACOBS, DONALD RICHARD (MD)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RICHARD
Last Name:JACOBS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6087 S QUEBEC ST
Mailing Address - Street 2:STE 103
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4540
Mailing Address - Country:US
Mailing Address - Phone:303-796-9232
Mailing Address - Fax:303-796-0324
Practice Address - Street 1:6075 SO QUEBEC
Practice Address - Street 2:STE 203
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-796-9232
Practice Address - Fax:303-796-0324
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COCO217362084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01217363Medicaid