Healthcare Provider Details

I. General information

NPI: 1306596135
Provider Name (Legal Business Name): JAKOB LELAND JOZWIAKOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 SMITH AVE N
SAINT PAUL MN
55102-2346
US

IV. Provider business mailing address

2450 RIVERSIDE AVE # M136
MINNEAPOLIS MN
55454-1450
US

V. Phone/Fax

Practice location:
  • Phone: 651-220-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number80386
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number80386
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: