Individual
JACOLBY SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219
(513) 584-7355
(513) 584-0431
Mailing address
2830 VICTORY PKWY, CINCINNATI, OH 45206-1785
(513) 585-6200
(513) 245-3672
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35136267
OH
2085R0202X
Diagnostic Radiology Physician
52706
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100597940
—
KY
Enumeration date
04/22/2014
Last updated
10/22/2025
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