Individual
DR. ELIZABETH MARIE JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
430 W 35TH ST, DAVENPORT, IA 52806-5820
(563) 391-2889
(563) 391-2988
Mailing address
430 W 35TH ST, DAVENPORT, IA 52806-5820
(563) 391-2889
(563) 391-2988
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
085216
IA
213ES0103X
Foot & Ankle Surgery Podiatrist
135.000811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085216
PROFESSIONAL LICENSE
IA
01
—
135.000811
PROFESSIONAL LICENSE
IL
Enumeration date
07/18/2013
Last updated
02/13/2019
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