Individual
DR. LOIS JEAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,PHD
Contact information
Practice address
1510 ARBORETUM DR, OSHKOSH, WI 54901-2790
(920) 231-5313
(920) 231-5348
Mailing address
1510 ARBORETUM DR, OSHKOSH, WI 54901-2790
(920) 231-5313
(920) 231-5348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30302
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202960478012
BCBSWI
WI
05
—
31609600
—
WI
Enumeration date
07/05/2005
Last updated
06/30/2008
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