Individual
ROBERT CARL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28761
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
28761
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050011524
RAILROAD-MEDICARE
NC
01
—
132EU
BCBS NC
NC
01
—
32892
PARTNERS
NC
01
—
57301
MEDCOST
NC
01
—
6724711
CIGNA
NC
05
—
89132EU
—
NC
Enumeration date
08/31/2006
Last updated
12/11/2007
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