Provider Demographics
NPI:1467447987
Name:FLOTTMANN, JAY THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:THOMAS
Last Name:FLOTTMANN
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 1:2917 S HAWKS LANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-6661
Mailing Address - Country:US
Mailing Address - Phone:830-237-8744
Mailing Address - Fax:
Practice Address - Street 1:2917 S HAWKS LANDING BLVD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:830-237-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023971171000000X, 2083A0100X
VA0101262075208D00000X
FLME134984208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice