Individual
DR. MARTIN A JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1410 BACON PARK DR, SAVANNAH, GA 31406-2008
(843) 240-2802
Mailing address
1410 BACON PARK DR, SAVANNAH, GA 31406-2008
(843) 240-2802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
062364
GA
207Q00000X
Family Medicine Physician
20613
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206137
—
SC
05
—
305678198A
—
GA
05
—
305678198B
—
GA
01
—
582203199-004
TRICARE
GA
01
—
582203199-009
TRICARE
GA
01
—
P00778515
RR MEDICARE
GA
Enumeration date
04/12/2006
Last updated
01/27/2010
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