Healthcare Provider Details

I. General information

NPI: 1013978626
Provider Name (Legal Business Name): JAY DAVID BAYER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 S ANTRIM WAY
GREENCASTLE PA
17225-1522
US

IV. Provider business mailing address

146 S ANTRIM WAY
GREENCASTLE PA
17225-1522
US

V. Phone/Fax

Practice location:
  • Phone: 717-597-2115
  • Fax: 717-597-2116
Mailing address:
  • Phone: 717-597-2115
  • Fax: 717-597-2116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05002807
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number05002807L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: