Individual
DR. WILLIAM JAY JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
245 BLOOMFIELD DR, SUITE 108, LITITZ, PA 17543-7788
(717) 517-7190
(717) 517-7379
Mailing address
245 BLOOMFIELD DR, SUITE 108, LITITZ, PA 17543-7788
(717) 517-7190
(717) 517-7379
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002450
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
397572
NATIONAL VISION ADMIN
—
01
—
5211416
AETNA
—
Enumeration date
10/20/2006
Last updated
08/30/2012
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