Provider Demographics
NPI:1295713840
Name:CLEMENS, JAY ARTHUR (DO)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:ARTHUR
Last Name:CLEMENS
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 1:16616 RIVERS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8068
Mailing Address - Country:US
Mailing Address - Phone:907-622-7958
Mailing Address - Fax:
Practice Address - Street 1:3 MEDICAL GROUP
Practice Address - Street 2:
Practice Address - City:ELMENDORF AFB
Practice Address - State:AK
Practice Address - Zip Code:99506-3702
Practice Address - Country:US
Practice Address - Phone:907-580-4018
Practice Address - Fax:907-580-4010
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG95782083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine