Male or Other

Dr. William Jacobson MD

Anatomic Pathology & Clinical Pathology Physician in Indianapolis, IN(View on Map)

Full Name

Dr. William Jacobson MD

NPI Number

1710964044

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/28/2005

Specialties

(Taxonomies)

Code

207ZP0102X

Primary Taxonomy

Yes

Licenses

State

Indiana

License Number

01025252A

Contact
Information

Purpose

Mailing
Location

Address

2560 N. SHADELAND AVE
2560 N. SHADELAND AVE

City

Indianapolis
Indianapolis

State

IN
IN

Postal Code

46219-1706
46219-1706

Country

US
US

Telephone Number

(317) 275-8072
(317) 275-8072

Identifiers

Identifier

000000344920

Identifier State

IN

Identifier Issuer

ANTHEM

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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