Provider Demographics
NPI:1245498989
Name:JACOBS, TRACY CHRISTINE
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:CHRISTINE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 DOUG BAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2013
Mailing Address - Country:US
Mailing Address - Phone:205-408-3933
Mailing Address - Fax:
Practice Address - Street 1:201 DOUG BAKER BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2013
Practice Address - Country:US
Practice Address - Phone:205-408-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine