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NPI Code Detail

MEDICARE: ROBERT G JACOBY M.D.

MEDICARE:   ROBERT G JACOBY  M.D.
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
12084N0400XNeurology PhysicianME171759FL
22084N0400XNeurology PhysicianMD29004ME
32084N0400XNeurology Physician37807MN
42084N0400XNeurology PhysicianMD2023-0126NM

Other Identifiers

General Provider Information

NPI Number : 1518961531
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT G JACOBY M.D.
Provider Business Mailing Address
First Line : 2300 MIAMI VALLEY DR
Second Line : STE 550
City : CENTERVILLE
State : OH
Zip : 45459-1298
Country : US
Telephone Number : 937-438-7500
Fax Number :
Provider Business Practice Location Address
First Line : 11215 METRO PKWY STE 100
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-1206
Country : US
Telephone Number : 239-208-2212
Fax Number : 239-208-3994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 01/17/2025

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