Provider Demographics
NPI:1487897807
Name:JACOBS, DONALD R (PT)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:JACOBS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 MULVANE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1690
Mailing Address - Country:US
Mailing Address - Phone:785-295-8045
Mailing Address - Fax:785-295-5415
Practice Address - Street 1:634 MULVANE
Practice Address - Street 2:SUITE 404
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1690
Practice Address - Country:US
Practice Address - Phone:785-296-8045
Practice Address - Fax:785-296-5415
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS1101891208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation