Provider Demographics
NPI:1861460313
Name:FLOYD, JAY WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:WILLIAM
Last Name:FLOYD
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 1:106 SHOPPERS WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0530
Mailing Address - Country:US
Mailing Address - Phone:912-275-8028
Mailing Address - Fax:
Practice Address - Street 1:106 SHOPPERS WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-0530
Practice Address - Country:US
Practice Address - Phone:912-275-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA073914207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG57545Medicare UPIN
GA15506R53Medicare PIN