Provider Demographics
NPI:1740374172
Name:FEIST, JAY T (DPM)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:T
Last Name:FEIST
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 933400
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0038
Mailing Address - Country:US
Mailing Address - Phone:513-574-2424
Mailing Address - Fax:513-574-2479
Practice Address - Street 1:4455 BRIDGETOWN ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211
Practice Address - Country:US
Practice Address - Phone:513-574-2424
Practice Address - Fax:513-574-2479
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002650213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0821454Medicaid
OHCD5236OtherRAILROAD MEDICARE GROUP
OH480023545OtherRAILROAD MEDICARE
OH0459267Medicaid
OH0821454Medicaid
OH480023545OtherRAILROAD MEDICARE
OH0459267Medicaid
OH4419150001Medicare NSC