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1437121829
KENNETH MICHAEL JACOB
FORT MYERS, FL
NPI
1437121829
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: MO R3D70)
Enumeration Date
2006-02-01
Last Update Date
2013-11-13
Business Address
Dr. KENNETH MICHAEL JACOB MD
19460 CALADESI DR
FORT MYERS, FL 33967-5572
Phone number: 913-707-0826
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Mailing Address
Dr. KENNETH MICHAEL JACOB MD
19460 CALADESI DR APT/SUITE
FORT MYERS, FL 33967-5572
Phone number: 913-707-0826
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