IndividualActive
Addison Jacobs, MD
NPI 1679109482 · Diagnostic Radiology Physician · Scott Air Force Base, IL
Provider details
- NPI number
- 1679109482
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 2026006949 (MO)
Practice location
310 W Losey St
Scott Air Force Base, IL 62225-5250
Phone: (618) 256-9355
Mailing address
310 W Losey St
Scott Air Force Base, IL 62225-5250
Registry dates
- Enumerated
- 2020-03-13
- Last updated
- 2026-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.