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General NPI Number Information
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NPI Number | 1275797227
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Entity Type | Individual
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Provider Name | NATHAN ALBERT JACOBSON MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 215 MCNEEL LN
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6054
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Country | US
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Telephone | 308-534-6655
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Fax | 308-534-6662
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Provider Business Mailing Address
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Address Line | 215 MCNEEL LN
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6054
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Country | US
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Telephone | 308-534-6655
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Fax | 308-534-6662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301095369
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 57780
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 28488
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License Number State | NE
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