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Individual

DR. JEFFREY MICHAEL JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
411 CANISTEO ST, HORNELL, NY 14843-2104
(607) 324-8255
(607) 324-8774
Mailing address
411 CANISTEO ST, HORNELL, NY 14843-2104
(607) 324-8255
(607) 324-8774

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101287638
VA
2085R0202X
Diagnostic Radiology Physician
Primary
168781-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000929320001
HEALTHNOW
NY
05
01718249
NY
01
10820256
CAQH
NY
01
178209FF
PREFERRED CARE
NY
01
198781
GREAT WEST LICENSE #
NY
01
7226804
AETNA
NY
Enumeration date
05/22/2006
Last updated
02/19/2026
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