Individual
IRWIN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4000 N 9TH ST, PHILA, PA 19140-2209
(215) 229-7800
(215) 229-3693
Mailing address
PO BOX 820933, PHILA, PA 19182-0933
(215) 926-9010
(215) 226-8286
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS002250L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000658424
—
PA
01
—
0019190
AETNA HMO
PA
01
—
0058370000
INDEPENDENCE BLUE CROSS
PA
01
—
041665
HIGHMARK BLUE SHIELD
PA
01
—
1418
BRAVO HEALTH
PA
01
—
30019058
KMHP
PA
01
—
3Y7795
HEALTH NET
PA
01
—
4088577
AETNA PPO
PA
01
—
P00264978
RR MEDICARE
PA
Enumeration date
12/20/2005
Last updated
07/18/2011
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