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NPI Code Detail

MEDICARE: DR. NANCY JACOBSON D.M.D.

MEDICARE: DR. NANCY JACOBSON D.M.D.
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
1122300000XDentistDN 12471FL
21223G0001XGeneral Practice Dentistry0112NC

General Provider Information

NPI Number : 1679530521
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY JACOBSON D.M.D.
Provider Business Mailing Address
First Line : EAST CAROLINA UNIVERSITY
Second Line : 1851 MACGREGOR DOWNS ROAD
City : GREENVILLE
State : NC
Zip : 27834
Country : US
Telephone Number : 252-737-7053
Fax Number : 252-737-7049
Provider Business Practice Location Address
First Line : EAST CAROLINA UNIVERSITY
Second Line : 1851 MACGREGOR DOWNS ROAD
City : GREENVILLE
State : NC
Zip : 27834
Country : US
Telephone Number : 252-737-7053
Fax Number : 252-737-7049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 03/07/2023

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