Harolds, Jay A

Harolds, Jay A is an individual health care provider with primary practice located at 3264 N Evergreen Dr Ne , Grand Rapids MI 49525-9746. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Harolds, Jay A can be contacted via phone (616) 363-7339.

Contact Information

Primary practice address
3264 N Evergreen Dr Ne Grand Rapids MI 49525-9746
Phone: (616) 363-7339
Fax: (616) 361-5828
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 12562 Oklahoma
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301097371 Michigan

Profile Details

NPI number 1720081649
LBN Legal business name Harolds, Jay A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Oct 6th, 2010 - about 14 years ago

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 1720081649 NPPES
Oklahoma MEDICAID 100009180A

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