MEDICARE: JACOB TAYLOR RAMSEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	01099785A	IN
2	2085R0202X	Diagnostic Radiology Physician	01099785A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01099785A	OTHER	IN	INDIANA PROFESSIONAL LICENSING AGENCY MEDICAL BOARD
2	MD487585	OTHER	PA	PA BOARD OF MEDICINE

General Provider Information

NPI Number	:	1295317972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB TAYLOR RAMSEY MD

Provider Business Mailing Address
First Line	:	550 UNIVERSITY BLVD RM 641
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-850-5286
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 UNIVERSITY BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-850-5286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2021
Last Update Date	:	06/10/2026

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