Organization
JACOBSON PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN R JACOBSON MD (OWNER)
(952) 303-2100
Entity
Organization
Contact information
Practice address
2518 SUPERIOR DR NW, STE 104, ROCHESTER, MN 55901-1988
(952) 303-2100
Mailing address
2518 SUPERIOR DRIVE NW, STE 104, ROCHESTER, MN 55902
(952) 303-2100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
43676
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053825600
—
MN
01
—
1104899830
NPI
MN
Enumeration date
08/09/2016
Last updated
08/09/2016
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