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Individual
IRWIN JACOBSON
Active
Individual
IRWIN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS002250L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000658424
—
PA
01
—
0019190
AETNA HMO
PA
01
—
0058370000
INDEPENDENCE BLUE CROSS
PA
01
—
041665
HIGHMARK BLUE SHIELD
PA
01
—
1418
BRAVO HEALTH
PA
01
—
30019058
KMHP
PA
01
—
3Y7795
HEALTH NET
PA
01
—
4088577
AETNA PPO
PA
01
—
P00264978
RR MEDICARE
PA
Enumeration date
12/20/2005
Last updated
07/18/2011
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