Organization
STAR CITY COSMETIC SURGERY LLC
Active
Other names
Jacobson Cosmetic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA PAIGE JACOBSON DO (PHYSICIAN/OWNER)
(402) 890-6249
Entity
Organization
Contact information
Practice address
1630 S 70TH ST STE 202, LINCOLN, NE 68506-1500
(531) 254-5458
(531) 254-5065
Mailing address
1630 S 70TH ST STE 202, LINCOLN, NE 68506-1500
(531) 254-5458
(531) 254-5065
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017014908
STATE MEDICAL LICENSE
MO
01
—
2369
STATE MEDICAL LICENSE
NE
Enumeration date
11/10/2021
Last updated
02/10/2022
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