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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

NPI # 1750494449
LBN Legal business name LEE R JACOBSON OD SC
Authorized official JENNIFER TURCOTT - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/16/2006
Last updated 10/01/2008 - About 18 years ago
Identifiers
WI Medicaid 38728100
WI Other DB1413 RR PTAN DB1413
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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