Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL BLAKE JACOB, PA-C
ActiveMR. MICHAEL BLAKE JACOB, PA-C is a Physician Assistant healthcare provider located in PLYMOUTH, Minnesota. NPI 1821502154 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · PLYMOUTH, MN
Registration Details
- NPI Number
- 1821502154
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 22, 2017 (8.7012429845048 yrs)
- Last Updated
- Mar 11, 2021
- Licenses
-
12595 (MN)12593 (MN)
Practice Information
- Address
-
2855 CAMPUS DRPLYMOUTH, MN, 554412649Browse MN providers · Browse ZIP 55441
- Phone
- 7635777000
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in PLYMOUTH, MN
| Name | Credential | NPI |
|---|---|---|
| LINDSAY A HAUGEN | PA-C | 1023068145 |
| AMY KAY BOSTIC | PA-C | 1467481994 |
| AMY LOUISE MOE | PA | 1457382137 |
| ERIC ENGLUND | PA | 1518999382 |
| RANDEE MCGOWN | PA | 1629097258 |
| GREGORY SCOTT WATKINS | PA | 1982626362 |
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.