Individual provider · Type 1 NPI

Michael Blake Jacob, PA-C

Physician Assistant · Plymouth, MN

NPI number 1821502154 Active

Practice location

2855 Campus Dr
Plymouth, MN 55441-2649

Call (763) 577-7000 Map

Mailing address

5600 Camerata Way Unit 221
St. Louis Park, MN 55416-5285

Other practice locations

  • 800 E 28th St, Minneapolis, MN 55407-3723 · (612) 863-4000

Specialties and licenses

TaxonomyCodeLicense
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X12595 (MN)
Physician Assistant Primary 363A00000X12593 (MN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1821502154

Michael Blake Jacob, PA-C's National Provider Identifier is 1821502154, issued on Nov 22, 2017. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Plymouth, MN. The record was last updated on Mar 11, 2021.