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General NPI Number Information
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NPI Number | 1508048760
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Entity Type | Organization
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Legal Business Name | LEONARD JACOBSON MD INC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 7770 COOPER RD SUITE 8
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City | CINCINNATI
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State | OH
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Zip | 45242-7744
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Country | US
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Telephone | 513-793-9040
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Fax | 513-793-9092
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Provider Business Mailing Address
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Address Line | 7770 COOPER RD SUITE 8
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City | CINCINNATI
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State | OH
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Zip | 45242-7744
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Country | US
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Telephone | 513-793-9040
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Fax | 513-793-9092
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEONARD JACOBSON
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Credential | M.D.
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Telephone | 513-793-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35030761
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License Number State | OH
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