Individual
SUSAN JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
114 N MAIN ST, ZIONSVILLE, IN 46077-1430
(317) 936-3970
(317) 943-9989
Mailing address
114 N MAIN ST, ZIONSVILLE, IN 46077-1430
(317) 936-3970
(317) 943-9989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01049258
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200270340
—
IN
Enumeration date
10/04/2006
Last updated
09/09/2025
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