Most Relevant Information
Provider Data
| NPI Number: | 1003455163 |
| Provider Name: | WAYNE R JACOBS |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | MA061359 |
Most Important Dates
| Enumeration Date: | 01/06/2020 |
| Last Updated: | 01/07/2021 |
Provider Practice Location
435 RIVER AVE
WILLIAMSPORT
PA
177013722
Practice Location Phone/Fax
| Phone: | 8669953937 |
| Fax: |
Provider Mailing Location
66 ENTERPRISE BLVD
ALLENWOOD
PA
178109260
Provider Mailing Phone/Fax
| Phone: | 5705386002 |
| Fax: |