Individual
DR. KIRK L JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
403 STAGELINE RD, HUDSON, WI 54016
(715) 531-6800
(715) 531-6801
Mailing address
403 STAGELINE RD, HUDSON, WI 54016
(715) 531-6800
(715) 531-6801
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
31131
WI
208600000X
Surgery Physician
36347
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31596400
—
WI
Enumeration date
02/08/2006
Last updated
04/22/2009
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