Organization
DAN G. JACOBSON, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN GREGORY JACOBSON M.D., M.S. (PRESIDENT)
(772) 286-1812
Entity
Organization
Contact information
Practice address
432 SE OSCEOLA ST, STUART, FL 34994-2577
(772) 286-1812
(772) 288-4784
Mailing address
432 SE OSCEOLA ST, STUART, FL 34994-2577
(772) 286-1812
(772) 288-4784
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01280
BLUE CROSS BLUE SHIELD OF FLORIDA AND VERY OLD MEDICARE ISSUED 041186
FL
Enumeration date
11/17/2009
Last updated
11/17/2009
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