Individual provider · Type 1 NPI

Jaisy Jacob

Diagnostic Radiology Physician · Detroit, MI

NPI number 1639468614 Active

Practice location

4100 John R St
Detroit, MI 48201-2013

Call (313) 576-9900 Map

Other practice locations

  • 3601 W 13 Mile Rd, Royal Oak, MI 48073 · (248) 898-6031

Specialties and licenses

TaxonomyCodeLicense
Body Imaging Physician 2085B0100X4301107800 (MI)
Diagnostic Radiology Physician Primary 2085R0202X4301107800 (MI)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1639468614

Jaisy Jacob's National Provider Identifier is 1639468614, issued on Mar 30, 2011. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Detroit, MI. The record was last updated on May 13, 2022.