Individual
DR. MARC S JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 N WILMOT RD STE B250, TUCSON, AZ 85712-4416
(520) 324-7840
(520) 324-7839
Mailing address
PO BOX 31235, TUCSON, AZ 85751-1235
(520) 324-4100
(520) 324-1406
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
162392
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
58728
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
549189
—
AZ
Enumeration date
11/09/2006
Last updated
08/18/2021
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