Basic Information
| Provider Information | |||||||||
| NPI: | 1356704365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORRISON | ||||||||
| FirstName: | JACOB | ||||||||
| MiddleName: | BENJMAIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 516 DELAWARE ST SE | ||||||||
| Address2: | 12-100 PHILLIPS WANGENSTEEN BUILDING | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126259900 | ||||||||
| FaxNumber: | 6126257950 | ||||||||
| Practice Location | |||||||||
| Address1: | 516 DELAWARE STREET SE | ||||||||
| Address2: | 12-100 PHILLIPS WANGENSTEEN BUILDING | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126259900 | ||||||||
| FaxNumber: | 6126257950 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2016 | ||||||||
| LastUpdateDate: | 05/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 67367 | MN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.