Shake, Jay G

Shake, Jay G is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Shake, Jay G can be contacted via phone (601) 984-5100.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 102316 Minnesota
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 23449 Mississippi
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X N8723 Texas
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X N8723 Texas

Profile Details

NPI number 1215967500
LBN Legal business name Shake, Jay G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated May 12th, 2015 - about 10 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 1215967500 NPPES
Minnesota MEDICAID 693630000
Minnesota MEDICAID 02358242

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