Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Richard Keith Jacob Jr., MD

Individual provider Surgery Physician · NPI 1316061179

Dr. Richard Keith Jacob Jr., MD is a General Surgery in Monroe, Georgia. Graduated from Texas Tech University Health Science Center School of Medicine in 2005, 21 years ago. Practices with Piedmont Providers LLC, a 518-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
21
Trained at
Texas Tech University Health Science Center School of Medicine
Licensed in
GA
In the registry since
2007
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

2151 W Spring St Ste B210
Monroe, GA 30655
Phone: (770) 207-5738
Fax: (770) 266-7346
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 58881 (GA)

Record details

NPI number1316061179
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 19, 2007
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolTEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Piedmont Providers Llc — 518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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