Individual
DR. GERI NEWMAN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 CENTRACARE CIR #1300, CENTRA CARE CLINIC WOMEN'S & CHILDRENS, ST CLOUD, MN 56303-5000
(320) 654-3610
(505) 722-1268
Mailing address
1900 CENTRACARE CIR #1300, CENTRA CARE CLINIC WOMEN'S & CHILDRENS, ST CLOUD, MN 56303-5000
(320) 654-3610
(505) 722-1268
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
39068
WI
208000000X
Pediatrics Physician
Primary
53579
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Z9493
—
NM
05
—
477225
—
AZ
Enumeration date
03/22/2006
Last updated
01/24/2012
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