Individual
KAI THOMAS JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4370 W MAIN ST, DOTHAN, AL 36305-1056
(334) 793-5000
Mailing address
271 PAXTON LOOP, DOTHAN, AL 36301
(612) 270-7762
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38996
AL
207R00000X
Internal Medicine Physician
38996
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03051522
—
MS
05
—
191835
—
AL
Enumeration date
06/07/2016
Last updated
11/16/2021
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