| Doctor Name: | DR. MICHAEL THOMAS JACOBSON |
| NPI Number: | 1902016504 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 4301053117 |
| Business Practice Address: | 205 Osceola St Laurium, MI - 499132134 |
| Business Phone Number: | 9063376500 |
| Business Fax Number: | 9063376597 |
| Mailing Address: | 205 Osceola St, LAURIUM |
| State: | MI |
| Postal Code: | 499132134 |
| Phone Number: | 9063376500 |
| Fax Number: | 9063376597 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | 4301053117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |