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Individual

GERALDINE M JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-7365
(813) 449-8618
Mailing address
PO BOX 9234, MORGANTOWN, WV 26506-9234
(304) 293-7227
(304) 598-4717

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
24703
WV
2085R0001X
Radiation Oncology Physician
34500
IA
2085R0001X
Radiation Oncology Physician
Primary
ME50372
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0254359
IA
05
3810022378
WV
01
44316
WELLMARK BCBS
IA
Enumeration date
08/10/2005
Last updated
01/23/2024
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