Most Relevant Information
Provider Data
| NPI Number: | 1003340472 |
| Provider Name: | JACOB A HUMPHREY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/12/2017 |
| Last Updated: | 08/16/2022 |
Provider Practice Location
3333 BURNET AVE
CINCINNATI
OH
45229
Practice Location Phone/Fax
| Phone: | 5136364531 |
| Fax: | 5136367407 |
Provider Mailing Location
3333 BURNET AVE, MLC 7022
CINCINNATI
OH
45229
Provider Mailing Phone/Fax
| Phone: | 5136364531 |
| Fax: | 5136367407 |