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Contact Information

LEE R JACOBSON OD SC
1357 SECOND AVE
CUMBERLAND, WI54829
 Phone: 715-822-2091
 Fax: 715-822-3624
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for LEE R JACOBSON OD SC · (Female)

NPI # 1750494449
Status Active
Credentials
Entity Individual
Enumeration date 08/16/2006
Last updated 10/01/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • WI Medicaid 38728100
  • WI Other DB1413 RR PTAN DB1413
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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