Individual
DR. RYAN CODY JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2411 HOLMES ST, KANSAS CITY, MO 64108-2741
(816) 235-6626
(816) 235-6629
Mailing address
14517 W 92ND ST, LENEXA, KS 66215-3060
(913) 599-2656
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-36348
KS
207P00000X
Emergency Medicine Physician
Primary
2007027058
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2006
Last updated
09/08/2014
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