Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 057121 | GA |
N | 111NI0900X | Internist | 057121 | GA |
N | 207R00000X | Internist | 20678 | WV |
N | 111NI0900X | Internist | 20678 | WV |
Y | 207R00000X | Internist | 43557 | KY |
Y | 111NI0900X | Internist | 43557 | KY |
NPI | 1932171675 |
---|---|
Provider Name | Dr. Darin Jacoby |
First Address | Paducah, KY 42002-9150 |
Second Address | Calhoun, KY 42327-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 25/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G46544 | (02) | GA |