Individual
DR. MICHAEL CRAIG JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 S EAGLE RD STE 3112, MERIDIAN, ID 83642-6352
(208) 706-5800
(208) 706-5810
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
6671934
ID
208800000X
Urology Physician
A97915
CA
Other
Enumeration date
11/09/2005
Last updated
01/10/2025
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