Provider Demographics
NPI:1447409198
Name:JACOBER, SCOTT JAY (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JAY
Last Name:JACOBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ELI LILLY AND COMPANY
Mailing Address - Street 2:546 S. MERIDIAN DROP CODE 6024
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46285-0001
Mailing Address - Country:US
Mailing Address - Phone:317-433-4281
Mailing Address - Fax:
Practice Address - Street 1:ELI LILLY AND COMPANY
Practice Address - Street 2:546 S. MERIDIAN DROP CODE 6024
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46285-0001
Practice Address - Country:US
Practice Address - Phone:317-433-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002393B207RE0101X
MI5101007754207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism