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Individual

DR. JULIET CHRISTINE JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD DPHI

Contact information

Practice address
55 FRUIT STREET, FND 600, BOSTON, MA 02114-2696
(617) 724-9197
(617) 724-8693
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-9197
(617) 724-8693

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
223973
MA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
223973
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2101076
MA
01
468394
TUFTS HEALTH PLAN
MA
01
J28570
BCBS MA
MA
Enumeration date
11/04/2005
Last updated
02/26/2020
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