Individual
JESSE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
435 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-8500
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
(651) 254-8500
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
201901598
NC
208800000X
Urology Physician
Primary
67498
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2014
Last updated
07/31/2020
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