Provider Demographics
NPI:1255822912
Name:ALDEN, JAY (DO)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:ALDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 MEMORIAL MEDICAL CT STE 1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4400
Mailing Address - Country:US
Mailing Address - Phone:864-295-3492
Mailing Address - Fax:864-295-4817
Practice Address - Street 1:8 MEMORIAL MEDICAL CT STE 1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4400
Practice Address - Country:US
Practice Address - Phone:864-295-3492
Practice Address - Fax:864-295-4817
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL51943207ZP0102X
SCDO51943207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology