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Organization

DAN G. JACOBSON, MD, PA

Active
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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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