Individual
JEROME R JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6101 CRILL AVE, PALATKA, FL 32177-3875
(386) 326-1225
Mailing address
6101 CRILL AVE, PALATKA, FL 32177-3875
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0059609
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370150600
—
FL
Enumeration date
08/01/2006
Last updated
10/22/2011
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