| Doctor Name: | DR. LISA ANN JACOBS |
| NPI Number: | 1225351042 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | MT178835 |
| Business Practice Address: | 251 Sunset Rd. Fitzwilliam, NH - 03447 |
| Business Phone Number: | 6172762357 |
| Business Fax Number: | |
| Mailing Address: | Po Box 488, WESTON |
| State: | MA |
| Postal Code: | 024930003 |
| Phone Number: | 7818999774 |
| Fax Number: | 7818999774 |
| NPI Enumeration Date: | 03/08/2010 |
| NPI Last Update Date: | 03/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MT178835 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |