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General NPI Number Information
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NPI Number | 1891798435
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Entity Type | Individual
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Provider Name | JAY MORITZ DPM
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1505 PROFESSIONAL CT
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City | DALTON
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State | GA
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Zip | 30720-2500
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Country | US
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Telephone | 706-259-6882
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Fax | 706-259-3786
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Provider Business Mailing Address
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Address Line | 1505 PROFESSIONAL CT
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City | DALTON
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State | GA
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Zip | 30720-2500
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Country | US
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Telephone | 706-259-6882
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Fax | 706-259-3786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD305042
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC004679R
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License Number State | PA
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