Organization
DR EARL JACOBSON LTD FOOT CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL JACOBSON (PRESIDENT)
(702) 384-2544
Entity
Organization
Contact information
Practice address
3650 S. EASTERN AVE, SUITE 200, LAS VEGAS, NV 89169-3345
(702) 384-2544
(702) 384-8528
Mailing address
3650 S. EASTERN AVE, SUITE 200, LAS VEGAS, NV 89169-3345
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
43
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002102804
—
NV
01
—
756480688
PALMETTO GBA RAILROAD
NV
01
—
NV5554
BCBS
NV
Enumeration date
08/12/2009
Last updated
04/01/2024
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