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NPI Code Detail

MEDICARE: DR. KURT E. JACOBSON M.D.

MEDICARE: DR. KURT E. 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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician024953GA

General Provider Information

NPI Number : 1578502530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KURT E. JACOBSON M.D.
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : FORTSON
State : GA
Zip : 31808-0370
Country : US
Telephone Number :
Fax Number : 706-494-3008
Provider Business Practice Location Address
First Line : 6262 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-3540
Country : US
Telephone Number : 706-324-6661
Fax Number : 706-327-6701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 06/04/2020

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