Healthcare Provider Details

I. General information

NPI: 1790604296
Provider Name (Legal Business Name): LYNN JACOBSON, M.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 E MAIN ST
LEXINGTON KY
40502-1668
US

IV. Provider business mailing address

710 E MAIN ST
LEXINGTON KY
40502-1668
US

V. Phone/Fax

Practice location:
  • Phone: 859-948-8606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: LYNN JACOBSON
Title or Position: MEMBER
Credential: MD
Phone: 859-948-8606