Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Clyde Tyrone Jacob III, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1972504488

Clyde Tyrone Jacob III, MD is an Obstetrics/Gynecology in Johns Creek, Georgia. Qualified in 1993, 33 years ago. Practices with Dhp of Manatee PA, a 47-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Delaware, Florida, Georgia and Indiana and 2 more.

Years since qualifying
33
Licensed in
DE, FL, GA, IN, NJ, NY
In the registry since
2005
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6325 Hospital Pkwy
Johns Creek, GA 30097-5775
Phone: (678) 474-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3950 Austell Rd, Austell, GA 30106-1121 — (770) 793-5913

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 81399 (GA)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 01089636A (IN)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 1999591 (NY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence ME162114 (FL)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence C1-0025884 (DE)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 25MA09347700 (NJ)

Record details

NPI number1972504488
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 9, 2005
Last updated in NPPESDecember 14, 2023
Certification dateAugust 10, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Dhp Of Manatee Pa — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Johns Creek