JAISY JACOB NPI 1639468614

NPI Information

NPI: 1639468614
Provider Name: JAISY JACOB
Classification: Radiology - 2085B0100X
Entity Type: Individual

Specialization: Body Imaging

Organization: BARBARA ANN KARMANOS CANCER INSTITUTE

PECOS Registration: Yes

Address:
4100 JOHN R ST
DETROIT, MI
ZIP 48201
Phone: (313) 576-9900
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Jaisy Jacob is a body imaging radiology in Detroit, MI with 13 years of experience. The provider is a Radiology doctor of Osteopathy that specializes in Body Imaging. Jaisy Jacob NPI is 1639468614. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4100 JOHN R ST
DETROIT, MI
ZIP 48201-013
Phone: (313) 576-9900

The NPI 1639468614 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/30/2011 and was last updated on 5/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	4301107800	MICHIGAN	Yes
2	2085R0202X	Radiology	Diagnostic Radiology	4301107800	MICHIGAN	No
3	390200000X	Student in an Organized Health Care Education/Training Program				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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