Provider Demographics
NPI:1013391911
Name:FLYNN, JAMIE (DO)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1321
Mailing Address - Country:US
Mailing Address - Phone:609-298-2005
Mailing Address - Fax:
Practice Address - Street 1:100 K JOHNSON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2275
Practice Address - Country:US
Practice Address - Phone:609-298-2005
Practice Address - Fax:609-324-8267
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10268200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine