Provider Demographics
NPI:1477545887
Name:NEUBAUER, JAY C (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:C
Last Name:NEUBAUER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FLUGPLATZ RAMSTEIN, GEB 2121
Mailing Address - Street 2:
Mailing Address - City:RAMSTEIN-MIESENBACH
Mailing Address - State:RHEINLAND-PFALZ
Mailing Address - Zip Code:66877
Mailing Address - Country:DE
Mailing Address - Phone:49637-147-7310
Mailing Address - Fax:
Practice Address - Street 1:2355 FACULTY DR
Practice Address - Street 2:
Practice Address - City:US AIR FORCE
Practice Address - State:CO
Practice Address - Zip Code:80840
Practice Address - Country:US
Practice Address - Phone:719-333-0533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010389542083A0100X
CODR00547452083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101038954OtherMEDICAL LICENSE