Provider Demographics
NPI:1700802444
Name:HORTENSTINE, JAY S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:S
Last Name:HORTENSTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5332 MOUNT VERNON RD
Mailing Address - Street 2:
Mailing Address - City:MURRAYVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30564-1404
Mailing Address - Country:US
Mailing Address - Phone:770-983-7587
Mailing Address - Fax:
Practice Address - Street 1:1315 JESSE JEWELL PKWY NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3822
Practice Address - Country:US
Practice Address - Phone:770-219-6520
Practice Address - Fax:770-219-6521
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA027068208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology