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Individual

DR. MICHAEL JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5408 DISCOVERY PARK BLVD, SUITE 300, WILLIAMSBURG, VA 23188-2893
(757) 253-8722
(757) 253-8726
Mailing address
901 ENTERPRISE PKWY, STE 300, HAMPTON, VA 23666-6249
(757) 825-2500
(757) 825-2500

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101233611
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006503446
VA
05
006503489
VA
Enumeration date
07/28/2005
Last updated
04/09/2020
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