Organization
LISA JACOBSON D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA JACOBSON D.O. (OWNER)
(231) 779-6260
Entity
Organization
Contact information
Practice address
8872 PROFESSIONAL DR, SUITE A, CADILLAC, MI 49601-8481
(231) 779-6260
(231) 779-6264
Mailing address
8872 PROFESSIONAL DR, SUITE A, CADILLAC, MI 49601-8481
(231) 779-6260
(231) 779-6264
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
5101013549
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4420424
—
MI
Enumeration date
04/23/2009
Last updated
07/11/2019
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