| Dr Geri Newman Jacobson, MD | |
|
1900 Centracare Cir #1300, Centra Care Clinic Women's & Childrens, St Cloud, MN 56303-5000 | |
| (320) 654-3610 | |
| (505) 722-1268 |
| Full Name | Dr Geri Newman Jacobson |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1900 Centracare Cir #1300, St Cloud, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558320044 | NPI | - | NPPES |
| 477225 | Medicaid | AZ | |
| 000Z9493 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 39068 (Wisconsin) | Secondary |
| 208000000X | Pediatrics | 53579 (Minnesota) | Primary |
| Entity Name | Centracare Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043212665 PECOS PAC ID: 2466363395 Enrollment ID: O20031105000293 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Geri Newman Jacobson, MD 1900 Centracare Cir #1300, Centra Care Clinic Women's & Childrens, St Cloud, MN 56303-5000 Ph: (320) 654-3610 | Dr Geri Newman Jacobson, MD 1900 Centracare Cir #1300, Centra Care Clinic Women's & Childrens, St Cloud, MN 56303-5000 Ph: (320) 654-3610 |
Jennifer J Rogan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1900 Centracare Circle, Centracare Clinic Womens & Childrens, St Cloud, MN 56303 Phone: 320-654-3630 | |
Oluade A. Ajayi, MBBS Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 Sixth Ave No, Centracare Clinic, St Cloud, MN 56303 Phone: 320-252-5731 | |
Tracey B Thompson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1200 Sixth Ave No, Centra Care Clinic, St Cloud, MN 56303 Phone: 320-240-2832 | |
Logan Andrew Newman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 Sixth Ave N, St Cloud, MN 56303 Phone: 320-251-2700 Fax: 320-656-7115 | |
Edward B Martin - Chafee, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1200 Sixth Ave N, St Cloud, MN 56303 Phone: 320-251-2700 Fax: 320-240-2118 | |
Dr. Marla J Moore, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303 Phone: 320-252-5731 Fax: 719-447-8987 | |
Kelly B Fandel, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1900 Centracare Circle, Centracare Clinic - Womens & Childrens, St Cloud, MN 56303 Phone: 320-654-3630 |