Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01083267A | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 048361 | GA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 65792-20 | WI |
NPI | 1174590152 |
---|---|
Provider Name | Dr. Robert L. Jacobson |
First Address | Columbus, GA 31902-1038 |
Second Address | Columbus, GA 31901-1525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 12/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
140938506 | (05) | TX |
300033584 | (05) | IN |
E93628 | (02) |