Basic Information
Provider Information
NPI: 1487882296
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOBE
FirstName: JEFFREY
MiddleName: TAYLOR
NamePrefix: MR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4310 JAMES CASEY ST STE 3C
Address2:  
City: AUSTIN
State: TX
PostalCode: 787451120
CountryCode: US
TelephoneNumber: 5123262800
FaxNumber: 5124416388
Practice Location
Address1: 4310 JAMES CASEY ST
Address2: SUITE 3C
City: AUSTIN
State: TX
PostalCode: 78745
CountryCode: US
TelephoneNumber: 5123262800
FaxNumber: 5124416388
Other Information
ProviderEnumerationDate: 06/30/2009
LastUpdateDate: 08/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XQ3024TXN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106XQ3024TXY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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