Ian M Jacobson
Emergency Physician
825 Chalkstone Ave
Providence
, Rhode Island 02908-4728
Ian M Jacobson
Emergency Physician
825 Chalkstone Ave
Providence
, Rhode Island 02908-4728
(330) 493-4443
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Ian M Jacobson
- 4535 Dressler Rd Nw
- Canton, OH
- Zip : 44718-2545
- Phone : (330) 493-4443
Second Address
- Ian M Jacobson
- 825 Chalkstone Ave
- Providence, RI
- Zip : 02908-4728
- Phone : (330) 493-4443
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | MD08888 | RI |
National Provider Identifier
| NPI | 1013057900 |
|---|---|
| Provider Name | Ian M Jacobson |
| First Address | Canton, OH 44718-2545 |
| Second Address | Providence, RI 02908-4728 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 7004811 | (05) | RI |
| E64424 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.