Jacob, Susan
Jacob, Susan is an individual health care provider with primary practice located at 10649 Bennett Pkwy , Zionsville IN 46077-7849. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jacob, Susan can be contacted via phone (317) 873-6700.Contact Information
Primary practice address
10649 Bennett Pkwy
Zionsville IN 46077-7849
Phone: (317) 873-6700
Fax: (317) 873-8200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01049258 | Indiana |
Profile Details
| NPI number | 1508951872 |
|---|---|
| LBN Legal business name | Jacob, Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Mar 22nd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508951872 | NPPES |
| Indiana | MEDICAID | 200270340 |
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