Jacobson, Michael D

Jacobson, Michael D is an individual health care provider with primary practice located at 2121 E Harmony Rd Suite 300, Fort Collins CO 80528-3400. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Jacobson, Michael D can be contacted via phone (970) 224-9102.

Contact Information

Primary practice address
2121 E Harmony Rd Suite 300 Fort Collins CO 80528-3400
Phone: (970) 224-9102
Fax: (970) 224-9112
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110002152 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA.0004358 Colorado

Profile Details

NPI number 1013959188
LBN Legal business name Jacobson, Michael D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Aug 16th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013959188 NPPES
Colorado MEDICAID 19730136

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