Individual
BRIAN SCOTT JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9840 WESTPOINT DR, SUITE 400, INDIANAPOLIS, IN 46256-3360
(317) 577-6056
(317) 577-6059
Mailing address
9840 WESTPOINT DR, SUITE 400, INDIANAPOLIS, IN 46256-3360
(317) 577-6056
(317) 577-6059
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01047166
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093418
ANTHEM ID #
IN
Enumeration date
11/01/2006
Last updated
07/08/2007
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