DR. MICHAEL DUANE JACOBSON (NPI# 1639390651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639390651 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DUANE JACOBSON |
| Credential | D.O. MPH |
| Practice Address |
2261 Philadelphia Dr Dayton OH 45406-1814 |
| Mailing Address |
4222 Tylersville Rd West Chester OH 45011-8634 |
| Practice Telephone | 9377346700 |
| Mailing Telephone | 5138601099 |
| Mailing Fax Number | 8886158287 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
34. 005720 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0249609 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 88 Mdg, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 454335529 | 9379382782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700406477 | Michael Pescatore Jacobson | Student in an Organized Health Care Education/Training Program | 8906 Maribou Ct, Highlands Ranch, CO 80130-3315 | 2020-04-22 |
| 1275947509 | Michael Jacobson | Dentist | 1101 N Hillcrest Rd, Beverly Hills, CA 90210-2614 | 2014-06-14 |
| 1609966142 | Michael Andrew Jacobson | Chiropractor | 3201 N 3rd St, Phoenix, AZ 85012-2631 | 2006-10-13 |
| 1366442600 | Michael Jacobson | Otolaryngology | 5408 Discovery Park Blvd, Suite 300, Williamsburg, VA 23188-2893 | 2005-07-28 |
| 1689870289 | Michael Evan Jacobson | Emergency Medicine | 8303 Dodge St, Omaha, NE 68114-4108 | 2007-06-21 |
| 1902016504 | Michael Thomas Jacobson | Family Medicine | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2007-05-23 |
| 1649352964 | Michael A Jacobson | Dermatology | 1051 Long Ridge Rd, Stamford, CT 06903-4436 | 2006-10-19 |
| 1891884185 | Michael Jacobson | Psychiatry & Neurology | 1 Nolte Dr, Kittanning, PA 16201-7111 | 2006-10-12 |
| 1831284249 | Michael Brian Jacobson | Pediatrics | 250 E Chase Ave, Suite 108, El Cajon, CA 92020-6305 | 2006-10-03 |
| 1316044563 | Michael Jacobson | Internal Medicine | 1421 3rd Ave, Ph, New York, NY 10028-1802 | 2006-09-20 |
| Street Address |
2261 PHILADELPHIA DR |
| City | DAYTON |
| State | OH |
| Zip Code | 45406-1814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851373286 | Elisabeth Lynn Righter | Family Medicine | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2005-11-21 |
| 1912521741 | Kaitlyn Paige Olsen | Social Worker | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2020-06-08 |
| 1811531957 | Jill Michelle Ohs | Pharmacist | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2019-11-01 |
| 1710530886 | Five Rivers Health Centers | Pharmacy | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2019-07-18 |
| 1407317159 | Kirthi Kavya Jetty | Student in an Organized Health Care Education/Training Program | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2019-03-26 |
| 1184110116 | Keishan Lavelle Dorsey | Counselor | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2018-07-02 |
| 1306365382 | Melissa Wilkes | Registered Nurse | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2017-09-11 |
| 1235661851 | Cassandra Olson | Student in an Organized Health Care Education/Training Program | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2017-04-02 |
| 1982053724 | Toni Tipton | Advanced Practice Midwife | 2261 Philadelphia Dr, Suite 200, Dayton, OH 45406-1814 | 2016-06-10 |
| 1841653193 | Sedona Valentine | Student in an Organized Health Care Education/Training Program | 2261 Philadelphia Dr, Dayton, OH 45406-1814 | 2016-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942786595 | Lawrence J Harper Jr. | Counselor | 1855 Kipling Dr, Dayton, OH 45406 | 2018-07-17 |
| 1114446937 | James Lee | Licensed Practical Nurse | 1687 Wesleyan Rd., Dayton, OH 45406 | 2017-09-13 |
| 1497280762 | Pam Taylor | Licensed Practical Nurse | 3339 Arlene Ave, Dayton, OH 45406 | 2017-04-25 |
| 1811428543 | Kimberly Hawkins | Licensed Practical Nurse | 3660 Pittsburg Ave, Dayton, OH 45406 | 2017-03-24 |
| 1760839187 | Micah Rejcek | Student in an Organized Health Care Education/Training Program | Five Rivers Family Health Center, 2261 Philadelphia Drive Suite 301, Dayton, OH 45406 | 2016-05-16 |
| 1134505233 | Julia Ahrns | Dietitian, Registered | 2261 Philadelphia Dr., Dayton, OH 45406 | 2015-07-31 |
| 1215314125 | Tracy Fong | Family Medicine | 2261 Philadelphia Drive, Dayton, OH 45406 | 2015-04-29 |
| 1518285337 | Johwanna Martin | Registered Nurse | 2055 Ravenwood Ave, Dayton, OH 45406 | 2010-05-05 |
| 1003051913 | Fawnette Thomas | Social Worker | 2116 University Place, Dayton, OH 45406 | 2008-12-05 |
| 1043478654 | Mvhe Inc | Hospitalist | 2661 Salem Ave Davue Building, Suite 220, Dayton, OH 45406 | 2008-05-30 |
| Find all providers in zip 45406 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639609548 | Cornerstone Project, LLC | Family Medicine | 4124 Linden Ave Ste 100, Dayton, OH 45432-3018 | 2017-06-13 |
| 1942656244 | Shirley Ann Johnson | Family Medicine | 8658 N Main St, Dayton, OH 45415-1328 | 2016-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907051 | Douglas Moinuddin | Family Medicine | 28360 Center Ridge Rd Apt 229, Westlake, OH 44145-6797 | 2020-06-23 |
| 1730726480 | Serenity Now Counseling and Treatment LLC | Family Medicine | 8308 Ohio River Rd Ste B, Wheelersburg, OH 45694-1713 | 2019-12-02 |
| 1689220352 | Hill Clinic, LLC | Family Medicine | 4425 Hill Ave, Toledo, OH 43615-5410 | 2019-08-17 |
| 1821654674 | Roman Family Healthcare | Family Medicine | 1440 State Route 28 W, Greenfield, OH 45123-8424 | 2019-05-17 |
| 1265997118 | Phoenix Integrated Health | Family Medicine | 5945 Sawmill Rd Unit B, Dublin, OH 43017-1623 | 2019-02-05 |
| 1124535828 | Ats, Columbus, LLC Dba, Addiction Therapy Services | Family Medicine | 4760 Sawmill Rd, Columbus, OH 43235-3260 | 2018-01-03 |
| 1326567512 | Far Reach Foundation | Family Medicine | 620 Bear Run Ln Ste B, Lewis Center, OH 43035-8299 | 2017-09-19 |
| 1639691629 | Cornerstone Clinics | Family Medicine | 802 Clare Ave Ste 101, Portsmouth, OH 45662-2583 | 2017-07-11 |
| 1548782816 | Monarch Health and Recovery LLC | Family Medicine | 22664 State Route 73, West Portsmouth, OH 45663-6365 | 2017-07-08 |
| 1275073553 | Phoenix Recovery Center, LLC | Family Medicine | 5945 Sawmill Rd, Dublin, OH 43017-1623 | 2017-03-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.