Individual
HAL M JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1920 DON WICKHAM DR, SUITE130, CLERMONT, FL 34711-1918
(352) 243-9709
(352) 243-8703
Mailing address
PO BOX 864460, ORLANDO, FL 32886-0001
(352) 243-9709
(352) 243-8703
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME0038736
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068606900
—
FL
01
—
110028619
RR MEDICARE LEESBURG
FL
Enumeration date
08/30/2005
Last updated
06/03/2015
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