Greg R Jacobsen (NPI# 1811105745, PAC ID# 9638221252) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1811105745 |
| PAC ID by PECOS | 9638221252 |
| Professional Enrollment ID | I20090713000465 |
| Full Name | Greg R Jacobsen |
| Organization Legal Name | SOUTHWEST SKIN AND CANCER LLC |
| Address |
383 S 300 St George UT 84770-3620 |
| Phone Number | 4356282826 |
| Gender | M |
| Medical School | TOLEDO MEDICAL COLLEGE |
| Graduation Year | 2005 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 4587675004 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460021 | DIXIE REGIONAL MEDICAL CENTER |
| 291307 | MESA VIEW REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 340 Falcon Ridge Pkwy, Suite 203, Mesquite, NV 89027-8851 | 4356282846 | SOUTHWEST SKIN AND CANCER LLC |
| 383 S 300, St George, UT 84770-3620 | 4356282826 | SOUTHWEST SKIN AND CANCER LLC |
| Organization Legal Name | SOUTHWEST SKIN AND CANCER LLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wallace Bret Smith | Dermatology | Southwest Skin and Cancer LLC | 383 S 300, St George, UT 84770-3620 |
| Timothy John Nowatzke | Physician Assistant | Southwest Skin and Cancer LLC | 383 S 300, St George, UT 84770-3620 |
| Wallace Austin Smith | Dermatology | Southwest Skin and Cancer LLC | 340 Falcon Ridge Pkwy, Suite 203, Mesquite, NV 89027-8851 |
| Scott Condie | Physician Assistant | Southwest Skin and Cancer LLC | 383 S 300, St George, UT 84770-3620 |
| Street Address |
383 S 300 |
| City | ST GEORGE |
| State | UT |
| Zip | 84770-3620 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wallace Bret Smith | Dermatology | Southwest Skin and Cancer LLC | 383 S 300, St George, UT 84770-3620 |
| Timothy John Nowatzke | Physician Assistant | Southwest Skin and Cancer LLC | 383 S 300, St George, UT 84770-3620 |
| Scott Condie | Physician Assistant | Southwest Skin and Cancer LLC | 383 S 300, St George, UT 84770-3620 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert S Mcknight | Chiropractic | 619 S Bluff St, Suite 100, Saint George, UT 84770-1232 | |
| Brett D Christiansen | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Richard A Sorensen | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Nathan L Holman | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Scott J Jolley | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Charles William Tate Iii | Cardiac Electrophysiology | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Jared Colton Cox | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Michael M Woodruff | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Nicholas Henry Laffely | Cardiovascular Disease (cardiology) | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Bradley J Crosby | Emergency Medicine | Ihc Health Services Inc | 1380 E Medical Ctr Dr, Drmc Critical Care Pulm, St George, UT 84770-2122 |
| Find all physicians in zip 84770 | |||
| City | ST GEORGE |
| Zip Code | 84770 |
| Specialty | DERMATOLOGY |
| City + Specialty | ST GEORGE + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.