Individual
DR. BRIAN C. JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
15 PARKMAN ST # STREET5, BOSTON, MA 02114-3117
(617) 724-6907
Mailing address
55 FRUIT STREET, WANG 5, BOSTON, MA 02114-2696
(617) 726-6609
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
153606
MA
207RG0100X
Gastroenterology Physician
Primary
153606
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110060654A
—
MA
Enumeration date
05/05/2006
Last updated
07/07/2020
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