Provider Demographics
NPI:1255381687
Name:ESTES, JACOB MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:MICHAEL
Last Name:ESTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-4165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25012207VX0201X
LAMD.201973207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051109016OtherBCBS
AL051527934OtherBCBS
AL121876Medicaid
AL051530395OtherBCBS
AL121891Medicaid
AL051527935OtherBLUE CROSS
AL051530395OtherBLUE CROSS
AL051545189OtherBCBS
LA1184349Medicaid
AL121881Medicaid
AL121887Medicaid
AL009992175Medicaid
AL051527935OtherBCBS
MS04729521Medicaid
AL051527932OtherBLUE CROSS
AL051527934OtherBLUE CROSS
AL009992135Medicaid
AL009992165Medicaid
AL051527933OtherBLUE CROSS
AL051527936OtherBLUE CROSS
ALP00881533OtherRAILROAD MEDICARE
AL121889Medicaid
AL009992145Medicaid
AL009992155Medicaid
AL051591469OtherBCBS
AL121886Medicaid
AL121887Medicaid
AL121886Medicaid