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Ryan Clinton Jacobs

Internal Medicine

Allopathic & Osteopathic Physicians

500 S Preston St Rm 305, Louisville, KY 40202-1702

PECOS Enrollment

This provider is enrolled in PECOS as RYAN JACOBS.

Based on the most recent information from CMS, provider Ryan Clinton Jacobs is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1740923556
Provider Type
Individual
Full Name
Jacobs, Ryan Clinton
Credential
MD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/19/2022
Last Updated
7/16/2024

Contact Information

Practice Location

500 S Preston St Rm 305, Louisville, KY 40202-1702

(502) 240-8912

Unlisted Fax

Mailing Location

2500 N State St, Jackson, MS 39216-4500

(502) 240-8912

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License T-5268 Mississippi

Ryan Clinton Jacobs

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Medical Center Internists, Psc

Rivera Matos, Lucia

Goldberg, Sarah Sloan

Tobias, Derrick Edward

Philip J. Feitelson, M.D. Psc

Chadalapaka, Naga

Gardon, Mark Anthony

Le, Hao Tuan

Williams, Patrick Murray