Provider Demographics
NPI:1669477535
Name:MCFARLANE, JAY DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:DOUGLAS
Last Name:MCFARLANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11030 N TATUM BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6073
Mailing Address - Country:US
Mailing Address - Phone:602-494-3037
Mailing Address - Fax:602-996-5274
Practice Address - Street 1:11030 N TATUM BLVD
Practice Address - Street 2:STE 102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6073
Practice Address - Country:US
Practice Address - Phone:602-494-3037
Practice Address - Fax:602-996-5274
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4890111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0249180OtherBLUE CROSS/BLUE SHIELD
AZZ120921Medicare PIN