Provider Demographics
NPI:1992091565
Name:RICHARD P. JACOBY DPM PC
Entity type:Organization
Organization Name:RICHARD P. JACOBY DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:JACOBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-994-5977
Mailing Address - Street 1:4747 N SCOTTSDALE RD STE C4005
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7666
Mailing Address - Country:US
Mailing Address - Phone:480-994-5977
Mailing Address - Fax:888-431-8819
Practice Address - Street 1:9475 E IRONWOOD SQUARE DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4576
Practice Address - Country:US
Practice Address - Phone:480-994-5977
Practice Address - Fax:480-672-2288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD P. JACOBY DPM PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-22
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty