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NPI Code Detail

MEDICARE: JARED G. CLAY M.D.

MEDICARE: JARED G. CLAY M.D.
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
1208600000XSurgery PhysicianA94014CA
2208600000XSurgery PhysicianDR-52995CO

General Provider Information

NPI Number : 1295719268
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARED G. CLAY M.D.
Provider Business Mailing Address
First Line : 4102 PINION DR
Second Line : 10 MDG
City : USAF ACADEMY
State : CO
Zip : 80840-2502
Country : US
Telephone Number : 719-333-5138
Fax Number : 719-333-5836
Provider Business Practice Location Address
First Line : 4102 PINION DR
Second Line : 10 MDG
City : USAF ACADEMY
State : CO
Zip : 80840-2502
Country : US
Telephone Number : 719-333-5138
Fax Number : 719-333-5836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 03/14/2018

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