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General NPI Number Information
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NPI Number | 1972063485
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Entity Type | Individual
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Provider Name | JACOB A. BRANDON MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 12174 N MERIDIAN ST STE 300
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City | CARMEL
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State | IN
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Zip | 46032-4578
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Country | US
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Telephone | 317-688-9000
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Fax | 317-680-9900
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Provider Business Mailing Address
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Address Line | 12174 N MERIDIAN ST STE 300
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City | CARMEL
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State | IN
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Zip | 46032-4578
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Country | US
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Telephone | 317-688-9000
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Fax | 317-680-9900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01086648A
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License Number State | IN
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