Provider Demographics
NPI:1215985593
Name:HELGASON, JAY WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:WALTER
Last Name:HELGASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6750
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03802-6750
Mailing Address - Country:US
Mailing Address - Phone:800-208-7069
Mailing Address - Fax:610-956-0020
Practice Address - Street 1:1111 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3151
Practice Address - Country:US
Practice Address - Phone:504-349-1461
Practice Address - Fax:504-349-1461
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0214422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1110400Medicaid
MS01888790Medicaid
H12546Medicare UPIN
LA4A943Medicare ID - Type Unspecified
LA1110400Medicaid