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Individual

KENNETH MITCHELL JACOBSOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF UROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-0805
(414) 805-0771
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF UROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-0805
(414) 805-0771

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
51655-020
WI
208800000X
Urology Physician
A98651
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679772164
WI
Enumeration date
07/13/2007
Last updated
02/01/2013
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