Provider Demographics
NPI:1285814202
Name:JAY J SCHINDLER MD PLLC
Entity Type:Organization
Organization Name:JAY J SCHINDLER MD PLLC
Other - Org Name:DAKOTA SPINE SUPPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:605-225-1272
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-0456
Mailing Address - Country:US
Mailing Address - Phone:605-225-1272
Mailing Address - Fax:605-225-1272
Practice Address - Street 1:2805 FIFTH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6003
Practice Address - Country:US
Practice Address - Phone:605-719-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAY J. SCHINDLER, MD, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5515332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD100136Medicaid
SDG65855Medicare UPIN