LESLIE JACOB MD NPI 1679647697

NPI Information

NPI: 1679647697
Provider Name: LESLIE JACOB, MD
Classification: Internal Medicine - 207RG0100X
Entity Type: Individual

Specialization: Gastroenterology

PECOS Registration: Yes

Address:
4200 SUN N LAKE BLVD
SEBRING, FL
ZIP 33872
Phone: (863) 402-3103
Get Directions

Leslie Jacob, MD is a gastroenterology internal medicine in Sebring, FL with 39 years of experience. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. Leslie Jacob, MD NPI is 1679647697. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4200 SUN N LAKE BLVD
SEBRING, FL
ZIP 33872-986
Phone: (863) 402-3103
Fax: (863) 402-5339

The NPI 1679647697 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 11/20/2006 and was last updated on 4/16/2024.

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	207RG0100X	Internal Medicine	Gastroenterology	0101280924	VIRGINIA	No
2	207RG0100X	Internal Medicine	Gastroenterology	ME66002	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	119868200	MEDICAID	FLORIDA
2	RM822	OTHER	FLORIDA	HFMG MA
3	100011557	OTHER	FLORIDA	RAILROAD MEDICARE
4	28906	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD OF FLA

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: 4/28/2024

NPI Synchronization or Removal

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