Individual
PAUL ANDERS JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 W FRONT ST, SUITE 100, TRAVERSE CITY, MI 49684-2236
(231) 935-0800
(231) 935-0808
Mailing address
701 W FRONT ST, SUITE 100, TRAVERSE CITY, MI 49684-2236
(231) 935-0800
(231) 935-0808
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
4301076134
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B81023
BCBSM
MI
05
—
4212842
—
MI
Enumeration date
06/21/2005
Last updated
10/22/2020
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