Jacob, Dennis M

Jacob, Dennis M is an individual health care provider with primary practice located at 1400 N Ritter Ave Suite 520, Indianapolis IN 46219-3052. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Jacob, Dennis M can be contacted via phone (317) 355-7220.

Contact Information

Primary practice address
1400 N Ritter Ave Suite 520 Indianapolis IN 46219-3052
Phone: (317) 355-7220
Fax: (317) 355-9672
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 01033979 Indiana

Profile Details

NPI number 1245262054
LBN Legal business name Jacob, Dennis M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Jun 11th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245262054 NPPES
Indiana Other P01198024 RR MEDICARE PTAN
Indiana MEDICAID 100366930A RR MEDICARE PTAN

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