Provider Demographics
NPI:1083654271
Name:SCHMIDT, JAY J (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:J
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:321 MULBERRY ST SW
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5720
Mailing Address - Country:US
Mailing Address - Phone:828-757-5965
Mailing Address - Fax:828-757-5104
Practice Address - Street 1:4355 HICKORY BLVD
Practice Address - Street 2:UPPER SUITE
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-1992
Practice Address - Country:US
Practice Address - Phone:828-757-5060
Practice Address - Fax:828-757-5064
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC93-00585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8974836Medicaid
NC74836OtherBCBS
NC8974836Medicaid
NC2193869DMedicare PIN