Individual
PAUL L. JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4000
Mailing address
7813 WAKELEY PLZ, OMAHA, NE 68114-3651
(402) 391-4855
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17974
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260747
MEDICARE
—
Enumeration date
09/28/2006
Last updated
10/30/2007
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