# LISA JACOBSON D.O., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831333715
- **Authorized official:** MRS. LISA JACOBSON D.O. (OWNER)
- **Authorized official phone:** (231) 779-6260

## Contact information

- **Practice address:** 8872 PROFESSIONAL DR, SUITE A, CADILLAC, MI 49601-8481
- **Practice address phone:** (231) 779-6260
- **Practice address fax:** (231) 779-6264
- **Mailing address:** 8872 PROFESSIONAL DR, SUITE A, CADILLAC, MI 49601-8481
- **Mailing address phone:** (231) 779-6260
- **Mailing address fax:** (231) 779-6264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 5101013549 | MI | Yes |

## Other

- **Enumeration date:** 04/23/2009
- **Last updated:** 07/11/2019