Michael Duane Jacobson, D.O. MPH

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

34. 005720 Issued in OH

Practice address

2261 Philadelphia Dr
Dayton, OH 45406-1814

Phone

(937) 734-6700

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Destiny Treatment Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Clinton, OH
  • NPI 1821411273

  Addiction Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1639390651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 TYLERSVILLE RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450118634",
            "telephone_number": "513-860-1099",
            "fax_number": "888-615-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 PHILADELPHIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454061814",
            "telephone_number": "937-734-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "88 MDG",
            "address_2": "4881 Sugar Maple Dr.",
            "address_purpose": "LOCATION",
            "city": "Wright-Patterson AFB",
            "state": "OH",
            "postal_code": "454335529",
            "country_code": "US",
            "telephone_number": "937-938-2782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MICHAEL",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.O. MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OH",
            "license": "34. 005720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0249609",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley S Jacobs, MD
• Donna M Jacobs
• Emily Jacobs, APRN, FNP-BC
• Keaplish Danell Jacobs, STNA
• Shari Jacobs, MS, RD
• Kathlene Jacoby, APRN
• Ali Turab Jaffery, M.D.
• Jennifer L Jahns, NP-C
• Samara Beth Jakeway, LSW
• James S Jambor, OD

• Addiction Medicine (Family Medicine) Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Addiction Medicine (Family Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.