Individual ProviderJeffrey JacobInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1439 Jesse Jewell Pkwy NE Ste 102, Gainesville, GA 30501-3806(770) 219-9445(770) 219-8420PECOS EnrollmentBased on the most recent information from CMS, provider Jeffrey Jacob is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1891324729Provider TypeIndividualFull NameJacob, JeffreyCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/3/2020Last Updated11/15/2023Contact InformationPractice LocationPractice Address1439 Jesse Jewell Pkwy NE Ste 102, Gainesville, GA 30501-3806Phone(770) 219-9445FaxUnlisted FaxMailing LocationMailing AddressPO Box 742616, Atlanta, GA 30374-2616Phone(770) 219-8420FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense95749Georgia