Provider Demographics
NPI:1316128432
Name:JACOME, FRANCISCO JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:JACOME
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 1:2101 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6706
Mailing Address - Country:US
Mailing Address - Phone:706-738-3359
Mailing Address - Fax:706-738-0565
Practice Address - Street 1:2101 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6706
Practice Address - Country:US
Practice Address - Phone:706-738-3359
Practice Address - Fax:706-738-0565
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA069014208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program