Ingram, Jay

Ingram, Jay is an individual health care provider with primary practice located at 130 Fisher Rd Unit 1 , Berlin VT 05602-8132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ingram, Jay can be contacted via phone (802) 371-4100.

Contact Information

Primary practice address
130 Fisher Rd Unit 1 Berlin VT 05602-8132
Phone: (802) 371-4100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.133104 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 042.0016745 Vermont

Profile Details

NPI number 1679968788
LBN Legal business name Ingram, Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2015
Last updated Apr 5th, 2023 - about 2 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 1679968788 NPPES
Ohio MEDICAID 0146486

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