Provider Demographics
NPI:1215033840
Name:JACOBS, ZACHARY DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:DAVID
Last Name:JACOBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4440 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3315
Mailing Address - Country:US
Mailing Address - Phone:816-531-0930
Mailing Address - Fax:816-531-2807
Practice Address - Street 1:4440 BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3315
Practice Address - Country:US
Practice Address - Phone:816-531-0930
Practice Address - Fax:816-531-2807
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009010345207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology