Dr LANCE GLEN JACOBSON is a male medical professional, specializing in Orthopedic Surgery. He graduated in 2012 from Medical College Of Wisconsin.
IDAHO PHYSICIAN SERVICES INC
3200 CHANNING WAY
SUITE A205
IDAHO FALLS
ID
834047586
Tel: 2085354580
| Npi | 1689940405 |
| Pac Id | 7517185499 |
| Professional Enrollment Id | I20181024000126 |
| Last Name | JACOBSON |
| First Name | LANCE |
| Middle Name | GLEN |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 2012 |
| Primary Specialty | ORTHOPEDIC SURGERY |
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| Organization Legal Name | IDAHO PHYSICIAN SERVICES INC |
| Group Practice Pac Id | 2163430943 |
| Number Of Group Practice Members | 9 |
| Line 1 Street Address | 3200 CHANNING WAY |
| Line 2 Street Address | SUITE A205 |
| Marker Of Address Line 2 Suppression | |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 834047586 |
| Phone Number | 2085354580 |
| Hospital Affiliation Ccn 1 | 130018 |
| Hospital Affiliation Lbn 1 | EASTERN IDAHO REGIONAL MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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