MEDICARE: DR. ROBERT L. JACOBSON 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
1	207VM0101X	Maternal & Fetal Medicine Physician	048361	GA
2	207VM0101X	Maternal & Fetal Medicine Physician	01083267A	IN
3	207VM0101X	Maternal & Fetal Medicine Physician	J0538	TX
4	207VM0101X	Maternal & Fetal Medicine Physician	25591	KY
5	207VX0000X	Obstetrics Physician	J0538	TX
6	207VM0101X	Maternal & Fetal Medicine Physician	65792-20	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174590152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L. JACOBSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1038
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31902-1038
Country	:	US
Telephone Number	:	706-571-1285
Fax Number	:	706-660-6518

Provider Business Practice Location Address
First Line	:	1968 NORTH AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-1525
Country	:	US
Telephone Number	:	706-571-1285
Fax Number	:	706-660-6518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	02/07/2024

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Directions to “ DR. ROBERT L. JACOBSON M.D.” Practice Location

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