Provider Demographics
NPI:1215937305
Name:SPRINGER, JAY MARK (MD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:MARK
Last Name:SPRINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 PARK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1574
Mailing Address - Country:US
Mailing Address - Phone:215-538-2004
Mailing Address - Fax:215-538-2015
Practice Address - Street 1:1021 PARK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1574
Practice Address - Country:US
Practice Address - Phone:215-538-2004
Practice Address - Fax:215-538-2015
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-018311-E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0048631000OtherKEYSTONE-EAST
PA2950210OtherAETNA
PA0009605810002Medicaid
C33156Medicare UPIN
PA0009605810002Medicaid