Individual
ANDRE JACK JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 PROVIDENCE DR STE 205, ANCHORAGE, AK 99508-4620
(907) 561-1510
Mailing address
3300 PROVIDENCE DR STE 205, ANCHORAGE, AK 99508-4620
(907) 561-1510
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200882
AK
Other
Enumeration date
04/03/2018
Last updated
09/07/2023
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