Individual
DR. BRUCE ROBERT JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36100 EUCLID AVE, SUITE 450, WILLOUGHBY, OH 44094-4456
(440) 946-9555
(440) 946-2223
Mailing address
2561 LANDER RD, PEPPER PIKE, OH 44124-4317
(440) 461-5666
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35048289
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0602351
—
OH
Enumeration date
12/15/2005
Last updated
02/27/2014
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