Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB SUP, DO
ActiveJACOB SUP, DO is a Family Medicine healthcare provider located in CALDWELL, Idaho. NPI 1295266401 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · CALDWELL, ID
Registration Details
- NPI Number
- 1295266401
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 21, 2017 (9.3979315678879 yrs)
- Last Updated
- Aug 7, 2020
- License
-
O-1402 (ID)
Practice Information
- Address
-
2005 ARLINGTON AVECALDWELL, ID, 836054808Browse ID providers · Browse ZIP 83605
- Phone
- 2084591025
- Fax
- 2084591080
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in CALDWELL, ID
| Name | Credential | NPI |
|---|---|---|
| STACY JANE LAMERS | DO | 1003867094 |
| BRANDON G ISAACS | DO | 1801833645 |
| LISA R KOLTES | MD | 1780626127 |
| RICHARD A AUGUSTUS | MD | 1699717793 |
| KEVIN J CHICOINE | MD | 1730121740 |
| SAMANTHA PORTENIER | MD | 1356385132 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.