| Jacobson Optometry Ltd | |
|
1801 W Knapp St Ste 3 Rice Lake WI 54868-1381 | |
| (715) 234-3113 | |
| (715) 234-2339 |
| Full Name | Jacobson Optometry Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 1801 W Knapp St Ste 3, Rice Lake, Wisconsin |
| Authorized Official Name and Position | Kevin E Jacobson (DOCTOR) |
| Authorized Official Contact | 7152343113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobson Optometry Ltd 1801 W Knapp St Ste 3 Rice Lake WI 54868-1381 Ph: (715) 234-3113 | Jacobson Optometry Ltd 1801 W Knapp St Ste 3 Rice Lake WI 54868-1381 Ph: (715) 234-3113 |
| NPI Number | 1255518635 |
|---|---|
| Provider Enumeration Date | 01/28/2008 |
| Last Update Date | 01/28/2008 |
| Medicare PECOS PAC ID | 5890812598 |
|---|---|
| Medicare Enrollment ID | O20101104000707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255518635 | NPI | - | NPPES |
| 38527700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kevin Edward Jacobson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306850961 PECOS PAC ID: 8224144159 Enrollment ID: I20101104000788 |
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