Organization
LESLIE W. JACOBSON, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE WALTER JACOBSON M.D. (DR)
(952) 927-7138
Entity
Organization
Contact information
Practice address
6533 DREW AVE S, EDINA, MN 55435-2103
(952) 927-7138
(952) 924-4021
Mailing address
6533 DREW AVE S, EDINA, MN 55435-2103
(952) 927-7138
(952) 924-4021
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14592
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767265900
—
MN
Enumeration date
06/11/2007
Last updated
11/28/2011
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