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Individual

F STIG JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 290-8707
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
27466
WI
208000000X
Pediatrics Physician
27466
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30738400
WI
Enumeration date
09/26/2006
Last updated
11/07/2012
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