Individual
PAUL M JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
650
WI
213EP1101X
Primary Podiatric Medicine Podiatrist
650
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43212000
—
WI
Enumeration date
06/23/2005
Last updated
05/22/2019
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