Individual
EVAN MICHAEL JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 323-6861
(859) 323-1194
Mailing address
245 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 323-6021
(859) 323-1670
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R4747
KY
2084P0800X
Psychiatry Physician
Primary
R4747
KY
Other
Enumeration date
03/27/2018
Last updated
10/14/2020
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