Organization
JON S JACOBSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON S. JACOBSON M.D. (OWNER)
(623) 974-5530
Entity
Organization
Contact information
Practice address
13943 N 91ST AVE, BLDG G, PEORIA, AZ 85381-3687
(623) 974-5530
Mailing address
PO BOX 4387, COTTONWOOD, AZ 86326-2620
(928) 634-0665
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14654
AZ
Other
Enumeration date
08/18/2006
Last updated
04/02/2009
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