Individual
DR. WILLIAM JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2560 N. SHADELAND AVE, SUITE A, INDIANAPOLIS, IN 46219-1706
(317) 275-8072
(317) 275-8018
Mailing address
2560 N. SHADELAND AVE, SUITE A, INDIANAPOLIS, IN 46219-1706
(317) 275-8072
(317) 275-8018
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01025252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344920
ANTHEM
IN
Enumeration date
12/28/2005
Last updated
07/08/2007
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