Provider Demographics
NPI:1922112754
Name:STRICKLAND, JAY C (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:C
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8415 OLD HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:AL
Mailing Address - Zip Code:35116-1232
Mailing Address - Country:US
Mailing Address - Phone:205-647-6222
Mailing Address - Fax:205-647-7987
Practice Address - Street 1:150 GILBREATH DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-2827
Practice Address - Country:US
Practice Address - Phone:205-274-3278
Practice Address - Fax:205-274-3276
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1056247367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL430019408OtherRR MEDICARE
AL000035306Medicaid
AL000074729Medicaid
AL051035306Medicare ID - Type Unspecified
AL430019408OtherRR MEDICARE