Cory J Jacobsen, MD
Individual provider Active NPI Aerospace Medicine Physician · McConnell Afb, KS
NPI 1457930265 · NPPES record last updated Nov 19, 2025
Key facts
- NPI
- 1457930265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Aerospace Medicine Physician 2083A0100X
- License
- 0101276392 (VA)
- Practice address
- 57950 Leavenworth St
McConnell Afb, KS 67221-3505 - Phone
- (316) 759-6300
- NPI assigned
- Apr 7, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101276392 | VA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101276392 | VA | |
| Aerospace Medicine Physician | 2083A0100X | 0101276392 | VA | Yes |
Addresses
Primary practice location
57950 Leavenworth St
McConnell Afb, KS 67221-3505
Mailing address
57950 Leavenworth St BLDG 250
McConnell Afb, KS 67221-3505
Phone (316) 759-6300
Other providers in McConnell Afb, KS
- Jeffrey Scott Hayes
- Cory Ryan Henderson
- Loralie Ellington Hodges
- Dorothy A Hogg
- Ty Hunt
- Timothy Edward Jankowski
- Laura Johnstad
- Kathryn Rachel Kocher
- Aaron Thomas Krance
- Diana Kathleen Laco
All providers in McConnell Afb, KS · Aerospace Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.