Individual
STEVEN VERGIL JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1445 N BELL ST, FREMONT, NE 68025-3534
(402) 727-9220
(402) 727-5625
Mailing address
PO BOX 72, FREMONT, NE 68026-0072
(402) 727-9220
(402) 727-5625
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
01542
IA
152W00000X
Optometrist
Primary
780
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410016544
PALMETTO GBA RAILROAD MED
NE
Enumeration date
07/31/2006
Last updated
04/19/2012
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