Individual
MICHAEL PESCATORE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2122 E HIGHLAND AVE STE 335, PHOENIX, AZ 85016-4760
(602) 824-8404
Mailing address
2122 E HIGHLAND AVE STE 335, PHOENIX, AZ 85016-4760
(602) 824-8404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006734RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0437964
—
OH
Enumeration date
04/22/2020
Last updated
06/20/2025
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