Provider Demographics
NPI:1699067066
Name:JACOBS AUDIOLOGY LLC
Entity type:Organization
Organization Name:JACOBS AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:301-860-1124
Mailing Address - Street 1:6915 LAUREL BOWIE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1725
Mailing Address - Country:US
Mailing Address - Phone:301-860-1124
Mailing Address - Fax:
Practice Address - Street 1:6915 LAUREL BOWIE RD STE 304
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1725
Practice Address - Country:US
Practice Address - Phone:301-860-1124
Practice Address - Fax:240-929-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment