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Contact Information

DALE G JACOBSON, MD
525 KENOSHA ST
#A
WALWORTH, WI53184
 Phone: 262-275-2101
 Fax: 262-275-0752
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for DALE G JACOBSON · (Male)

NPI Number 1346357860
Status Active
Credentials MD
Entity Individual
Enumeration date 08/23/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 23975
  • WI Medicaid 30394600
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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