Individual
MARY R JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 N UNIVERSITY BLVD, UH 2180, INDIANAPOLIS, IN 46202-2879
(317) 944-7718
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
01043640
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200026240
—
IN
Enumeration date
04/25/2006
Last updated
11/17/2020
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