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Individual

KAREN J JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1509 HAWKSVIEW DR, MARION, IN 46952-1583
(765) 661-2530
Mailing address
1509 HAWKSVIEW DR, MARION, IN 46952-1583
(765) 661-2530

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
02002238A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001045074
ANTHEM
IN
05
200283250A
IN
Enumeration date
10/28/2005
Last updated
09/23/2024
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