Jacobsen, Grant

Jacobsen, Grant is an individual health care provider with primary practice located at 500 W Fort St # 111R , Boise ID 83702-4599. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Jacobsen, Grant can be contacted via phone (208) 422-1000.

Contact Information

Primary practice address
500 W Fort St # 111R Boise ID 83702-4599
Phone: (208) 422-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 7271468 Idaho
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MDRE.ML.70106827 Washington

Profile Details

NPI number 1306647581
LBN Legal business name Jacobsen, Grant
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2025
Last updated Jun 25th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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