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Contact Information

ELIZABETH S JACOBS, MD
593 EDDY ST
CLAVERICK 2
PROVIDENCE, RI02903
 Phone: 401-519-1604
 Fax: 401-272-0538
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Emergency Medicine

2080P0204X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ELIZABETH S JACOBS · (Female)

NPI Number 1871516963
Status Active
Credentials MD
Entity Individual
Enumeration date 07/26/2006
Last updated 02/12/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • RI License # MD12366
  • MA Medicaid 2135001
  • RI Medicaid 1871516
  • MA Other 12/29/2008 TUFTS HEALTH PLAN
  • RI Other 07/24/2007 BCBS
  • RI Other 09/13/2007 NHPRI
  • RI Other 1871516963 NPI
  • RI Other 007059436 RI MEDICARE
  • RI Other 939025129 RI MEDICARE GROUP NUMBER
  • RI Other 04/15/2009 UNITED HEALTHCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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