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Contact Information

THOMAS E JACOBSEN, MD
1000 HIGHWAY 12
HETTINGER, ND58639
 Phone: 701-567-4561
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for THOMAS E JACOBSEN · (Male)

NPI Number 1053405662
Status Active
Credentials MD
Entity Individual
Enumeration date 10/03/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • ND License # 2916
  • ND Medicaid 12564
  • NE Medicaid 45034068812
  • SD Medicaid 7774910
  • WA Medicaid 3018140
  • Other 10775 ND BC/BS
  • Other 20818 SIOUX VALLEY
  • Other 123993 WORKERS COMP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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