Provider Demographics
NPI:1710429303
Name:CLAIRMONT, JACOB JOEL (PA)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:JOEL
Last Name:CLAIRMONT
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:984-215-4111
Mailing Address - Fax:
Practice Address - Street 1:1617 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-9021
Practice Address - Country:US
Practice Address - Phone:984-215-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2025-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN12218363A00000X
NC0010-12145363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant