Dieckhoff, Jay William

Dieckhoff, Jay William is an individual health care provider with primary practice located at 1005 Broadway St , Quincy IL 62301-2834. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Dieckhoff, Jay William can be contacted via phone (217) 223-8400.

Contact Information

Primary practice address
1005 Broadway St Quincy IL 62301-2834
Phone: (217) 223-8400
Fax: (217) 223-9945
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036-064968 Illinois

Profile Details

NPI number 1962533695
LBN Legal business name Dieckhoff, Jay William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Nov 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962533695 NPPES
Illinois Other 00115241 BLUE SHIELD
Illinois MEDICAID 036064968 BLUE SHIELD
Illinois Other 110123 BLUE SHIELD

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