Provider Demographics
NPI:1003089954
Name:JAY H. SCHWARTZ, M.D., P.A.
Entity type:Organization
Organization Name:JAY H. SCHWARTZ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-334-1033
Mailing Address - Street 1:PO BOX 18001
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39122
Mailing Address - Country:US
Mailing Address - Phone:601-334-1033
Mailing Address - Fax:601-897-0198
Practice Address - Street 1:131 JEFFERSON DAVIS BLVD SUITE B
Practice Address - Street 2:SUITE B
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-334-1033
Practice Address - Fax:601-897-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18289208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00151543Medicaid
MS020000536OtherMEDICARE PROVIDER
MSC00350OtherMEDICARE GROUP
MS020000536OtherMEDICARE PROVIDER