MEDICARE: DR. JAY TIMOTHY AMES MD

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	207Q00000X	Family Medicine Physician	01035822	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	:	1538158134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY TIMOTHY AMES MD

Provider Business Mailing Address
First Line	:	951 TRANSPORT DR
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-8434
Country	:	US
Telephone Number	:	219-462-7173
Fax Number	:	219-465-9502

Provider Business Practice Location Address
First Line	:	751 E PORTER AVE STE 5
Second Line	:
City	:	CHESTERTON
State	:	IN
Zip	:	46304-9111
Country	:	US
Telephone Number	:	219-767-4858
Fax Number	:	219-406-8129

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	11/25/2020

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