Individual
LAUREN P. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 962-3400
(317) 944-0208
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
01086149A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103372281
—
PA
05
—
300051783
—
IN
Enumeration date
04/07/2014
Last updated
07/15/2021
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