# IRWIN JACOBSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1215913348
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | OS002250L | PA | Yes |

## Other

- **Enumeration date:** 12/20/2005
- **Last updated:** 07/18/2011

## 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 |