Provider Demographics
NPI:1366497711
Name:JAY L SCHWARTZ DO PC
Entity Type:Organization
Organization Name:JAY L SCHWARTZ DO PC
Other - Org Name:SCHWARTZ LASER EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-483-3937
Mailing Address - Street 1:8416 E SHEA BLVD
Mailing Address - Street 2:STE C-101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-483-3937
Mailing Address - Fax:480-483-8813
Practice Address - Street 1:8416 E SHEA BLVD
Practice Address - Street 2:STE C-101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-483-3937
Practice Address - Fax:480-483-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5440060001OtherCIGNA REGION D DMERC PEN
5440060002OtherCIGNA REGION D DMERC PEN
10042Medicare ID - Type Unspecified