Organization Name: | DONALD M. JACOBSON, MD SC |
NPI Number: | 1043514391 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOAN JACOBSON (VICE PRESIDENT) |
Mailing Address: | 3701 Durand Ave Ste 325 Racine |
State: | WI US |
Postal Code: | 534054480 |
Phone Number: | 2625989030 |
Fax Number: | 2625989032 |
NPI Enumeration Date: | 12/30/2010 |
NPI Last Update Date: | 12/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 33729 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |