Jacobson, Richard Y
Jacobson, Richard Y is an individual health care provider with primary practice located at 1428 2Nd Ave N Medical Arts Bldg, Fort Dodge IA 50501-4119. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jacobson, Richard Y can be contacted via phone (515) 573-1145.Contact Information
Primary practice address
1428 2Nd Ave N Medical Arts Bldg
Fort Dodge IA 50501-4119
Phone: (515) 573-1145
Fax: (515) 573-1028
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1536 | Iowa |
Profile Details
| NPI number | 1053399691 |
|---|---|
| LBN Legal business name | Jacobson, Richard Y |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Feb 25th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053399691 | NPPES |
| Iowa | Other | 07134 | BC/BS |
| Iowa | MEDICAID | 3066183 | BC/BS |
| Iowa | Other | IB1233001 | BC/BS |
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