Lacey Kristine Jacobs, PA-C

NPI #1891066445 in Oklahoma City, Oklahoma

Provider Information

NPI Number: 1891066445
Entity Type: Individual
Name: Lacey Kristine Jacobs, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jan 13, 2012
Last Updated: Jan 13, 2012

Practice Location

Address: 11601 S. WESTERN AVE
City: Oklahoma City
State: Oklahoma
ZIP Code: 73170-5823
Phone: (405) 512-6950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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