Provider Demographics
NPI:1043347222
Name:AKIN, JAY DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:DALE
Last Name:AKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-2092
Mailing Address - Country:US
Mailing Address - Phone:304-675-4340
Mailing Address - Fax:830-532-0165
Practice Address - Street 1:2520 VALLEY DR
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-2092
Practice Address - Country:US
Practice Address - Phone:304-675-4340
Practice Address - Fax:830-532-0165
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9783207Q00000X
WV3226207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081RROtherBCBS TX
TX8HJ991OtherBCBS
TX314971ZP2ZOtherMEDICARE
TX198858601Medicaid
TX198858604Medicaid