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5040 Bob Billings Pkwy Ste A1 Lawrence KS 66049-3873 | |
| (785) 764-1357 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 5040 Bob Billings Pkwy Ste A1, Lawrence, Kansas |
| Authorized Official Name and Position | John D Jacobson (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7857641357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
243 Earhart Cir Lawrence KS 66049-4739 Ph: (785) 764-1357 | 5040 Bob Billings Pkwy Ste A1 Lawrence KS 66049-3873 Ph: (785) 764-1357 |
| NPI Number | 1336621853 |
|---|---|
| Provider Enumeration Date | 08/31/2018 |
| Last Update Date | 10/27/2022 |
| Certification Date | 10/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336621853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2599 (Kansas) | Primary |
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