RICHARD ALBERT JACOB PA-C NPI 1720530934

NPI Information

NPI: 1720530934
Provider Name: RICHARD ALBERT JACOB, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: LEXINGTON HEALTH INC

PECOS Registration: Yes

Address:
2728 SUNSET BLVD STE 400
WEST COLUMBIA, SC
ZIP 29169
Phone: (803) 936-7095
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Richard Albert Jacob, PA-C is a surgical physician assistant in West Columbia, SC with 8 years of experience. Richard Albert Jacob, PA-C NPI is 1720530934. 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:

2728 SUNSET BLVD STE 400
WEST COLUMBIA, SC
ZIP 29169-839
Phone: (803) 936-7095
Fax: (803) 936-7908

The NPI 1720530934 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 11/4/2016 and was last updated on 11/6/2020.

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	363AS0400X	Physician Assistant	Surgical	2671	SOUTH CAROLINA	Yes

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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