Individual provider · Type 1 NPI

Richard Albert Jacob, PA-C

Surgical Physician Assistant · West Columbia, SC

NPI number 1720530934 Active

Practice location

2728 Sunset Blvd Ste 400
West Columbia, SC 29169-4839

Call (803) 936-7095 Map

Fax (803) 936-7908

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X2671 (SC)

Surgical Physician Assistant: Definition to come...

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About NPI 1720530934

Richard Albert Jacob, PA-C's National Provider Identifier is 1720530934, issued on Nov 4, 2016. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in West Columbia, SC. The record was last updated on Nov 6, 2020.