Jacobson, Peter C

Jacobson, Peter C is an individual health care provider with primary practice located at 1849 Old Donation Pkwy , Virginia Beach VA 23454-3004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Jacobson, Peter C can be contacted via phone (757) 422-8476.

Contact Information

Primary practice address
1849 Old Donation Pkwy Virginia Beach VA 23454-3004
Phone: (757) 422-8476
Fax: (757) 213-4332
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 0101041104 Virginia

Profile Details

NPI number 1770505703
LBN Legal business name Jacobson, Peter C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Sep 2nd, 2020 - about 4 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 1770505703 NPPES
Virginia MEDICAID 6409628

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