Provider Demographics
NPI:1588667513
Name:SOLORIO, JAY RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:RICHARD
Last Name:SOLORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5776
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-0776
Mailing Address - Country:US
Mailing Address - Phone:256-353-8811
Mailing Address - Fax:256-301-6196
Practice Address - Street 1:2828 HIGHWAY 31 S
Practice Address - Street 2:STE 112
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1538
Practice Address - Country:US
Practice Address - Phone:256-353-8811
Practice Address - Fax:256-301-6196
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13433207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051092359OtherHARTSELLE OFFICE BCBS #
AL000092359Medicaid
AL051060664OtherDECATUR OFFICE BCBS #
AL000060664Medicaid
AL000060664Medicare PIN
AL000092359Medicare PIN
AL0719500001Medicare NSC
AL051060664OtherDECATUR OFFICE BCBS #