Provider Demographics
NPI:1649461708
Name:JACOB, SHARON LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LEIGH
Last Name:JACOB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 NEW YORK AVENUE
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-1805
Mailing Address - Country:US
Mailing Address - Phone:610-838-1891
Mailing Address - Fax:
Practice Address - Street 1:801 OSTRUM STREET
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015
Practice Address - Country:US
Practice Address - Phone:610-954-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT185290207P00000X
PAMD433049207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine