Individual
WILLIAM C JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12499 UNIVERSITY AVE, SUITE 210, DES MOINES, IA 50325-8281
(515) 440-2676
(515) 440-2677
Mailing address
12499 UNIVERSITY AVE, SUITE 210, DES MOINES, IA 50325-8281
(515) 440-2676
(515) 440-2677
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
33389
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200044900
RAILROAD MEDICARE
IA
05
—
2205187
—
IA
01
—
43972
BLUE CROSS BLUE SHIELD
—
Enumeration date
04/12/2006
Last updated
01/22/2013
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