Jacobson, Lisa Waite

Jacobson, Lisa Waite is an sole proprietor health care provider with primary practice located at 8872 Professional Dr , Cadillac MI 49601-8481. She recently has only one registered license in Allopathic & Osteopathic Physicians / Facial Plastic Surgery, which is considered as her primary health care specialty. Jacobson, Lisa Waite can be contacted via phone (231) 779-6260.

Contact Information

Primary practice address
8872 Professional Dr Cadillac MI 49601-8481
Fax: (231) 779-6264
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 5101013549 Michigan

Profile Details

NPI number 1922073766
LBN Legal business name Jacobson, Lisa Waite
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2006
Last updated Oct 24th, 2007 - about 19 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1922073766 NPPES
Michigan MEDICAID 4420424

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