Individual
JOHN J JACOBSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 FORD ST, OGDENSBURG, NY 13669
(315) 393-7171
(315) 393-2382
Mailing address
301 FORD ST, OGDENSBURG, NY 13669
(315) 393-7171
(315) 393-2382
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1670291
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01076484
—
NY
Enumeration date
11/18/2005
Last updated
07/08/2007
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