MEDICARE: JACOB M SCHLOSSER DC

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	111N00000X	Chiropractor	08003203A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619569381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB M SCHLOSSER DC

Provider Business Mailing Address
First Line	:	1105 N WESTERN AVE
Second Line	:
City	:	MARION
State	:	IN
Zip	:	46952-2501
Country	:	US
Telephone Number	:	765-664-2479
Fax Number	:	765-662-1625

Provider Business Practice Location Address
First Line	:	1105 N WESTERN AVE
Second Line	:
City	:	MARION
State	:	IN
Zip	:	46952-2501
Country	:	US
Telephone Number	:	765-664-2479
Fax Number	:

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

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	04/21/2025

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