NPI 1760492656

Charles a Jacobson, MD

Practitioner Orthopaedic Surgery Physician Moscow, ID

Practice location

Address: 2500 W a St Suite 201, Moscow, ID 83843-5065
Phone: (208) 883-2828
Fax: (208) 882-2179

Registered specialties (2)

Orthopaedic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207X00000X Licence M6567 (ID)

Other Orthopaedic Surgery providers in Idaho →

Orthopaedic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207X00000X Licence 31851 (WA)

Registry record

NPI: 1760492656
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2006
Record last updated: 4 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.