Individual
DR. HART JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 PHEASANT RUN DR, LANDER, WY 82520-9783
(307) 332-3115
Mailing address
30 PHEASANT RUN DR, LANDER, WY 82520-9783
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2675A
WY
Other
Enumeration date
11/03/2009
Last updated
11/03/2009
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