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NPI Code Detail

MEDICARE: DR. MARTIN AARON JACOBSON MD

MEDICARE: DR. MARTIN AARON JACOBSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianPA020798E MDPA

General Provider Information

NPI Number : 1063409712
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTIN AARON JACOBSON MD
Provider Business Mailing Address
First Line : 4201 KUTZTOWN RD
Second Line :
City : TEMPLE
State : PA
Zip : 19560-1836
Country : US
Telephone Number : 610-921-2094
Fax Number : 610-921-1235
Provider Business Practice Location Address
First Line : 4201 KUTZTOWN RD
Second Line :
City : TEMPLE
State : PA
Zip : 19560-1836
Country : US
Telephone Number : 610-921-2094
Fax Number : 610-921-1235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2005
Last Update Date : 03/21/2012

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