Basic Information
| Provider Information | |||||||||
| NPI: | 1346660883 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAY | ||||||||
| FirstName: | JEREMY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 OSBORN BLVD | ||||||||
| Address2: | |||||||||
| City: | SAULT SAINTE MARIE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497831822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9062532665 | ||||||||
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| Practice Location | |||||||||
| Address1: | 203 NACOGDOCHES ST STE 280 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757662444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035415396 | ||||||||
| FaxNumber: | 9035415393 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2014 | ||||||||
| LastUpdateDate: | 07/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301112753 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.