Search › Georgia › 208000000X
Thomas Jacob, M.D
NPI 1215295449 · on the registry since 2012 · sole proprietor
Practice
- Address
- 760 Kennesaw Ave Nw
Marietta, GA 30060 - Phone
- (770) 427-0183
- Organisation at this address
- Wellstar Medical Group, Llc
Wellstar Kenmar Pediatrics, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 12
Additional practice sites
- 4201 Torrance Blvd Ste 660, Torrance, CA
- 200 Ucla Medical Plz Ste 265, Los Angeles, CA
- 757 Westwood Plz, Los Angeles, CA
Registry record
- Primary taxonomy
- 208000000X
208000000X
- Also registered as
- 208000000X
- Licence states on file
- CA, GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-07-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia