Individual
DOUGLAS JOHN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8917
(602) 262-8890
Mailing address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8917
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37008
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241517
—
AZ
Enumeration date
08/10/2007
Last updated
07/20/2021
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