Active NPI
Arnold Fred Jacobson, MD
- In Vivo & In Vitro Nuclear Medicine Physician
- Kihei, HI
National Provider Identifier
1679933428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Vivo & In Vitro Nuclear Medicine Physician
- License
- 00024989
- Practice address
- 10 Lio Poele PL
Kihei, HI 96753-7155 - Phone
- (808) 214-5366
- NPI assigned
- Mar 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Vivo & In Vitro Nuclear Medicine Physician | 207UN0903X | 00024989 | WA | Primary |
Addresses
Primary practice location
10 Lio Poele PL
Kihei, HI 96753-7155
Mailing address
10 Lio Poele PL
Kihei, HI 96753-7155
Phone (808) 214-5366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00024989 | WA | MD | In Vivo & In Vitro Nuclear Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457308800000",
"number": "1679933428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 LIO POELE PL",
"city": "KIHEI",
"state": "HI",
"postal_code": "967537155",
"telephone_number": "808-214-5366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 LIO POELE PL",
"city": "KIHEI",
"state": "HI",
"postal_code": "967537155",
"telephone_number": "808-214-5366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "ARNOLD",
"middle_name": "FRED",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-07",
"last_updated": "2016-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207UN0903X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
"state": "WA",
"license": "00024989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kihei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.