Dr. Jay Allen Lugthart
General Practice Physician Emergency Medical Services Family Doctor - Geriatric Medicine
670 Baldwin St
Jenison
, Michigan 49428-9757
Dr. Jay Allen Lugthart
General Practice Physician Emergency Medical Services Family Doctor - Geriatric Medicine
670 Baldwin St
Jenison
, Michigan 49428-9757
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About
Features
Specialties
- Emergency Medical Services
- Family Doctor - Geriatric Medicine
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Jay Allen Lugthart
- 4419 68th St Sw
- Byron Center, MI
- Zip : 49315-9428
- Phone :
Second Address
- Dr. Jay Allen Lugthart
- 670 Baldwin St
- Jenison, MI
- Zip : 49428-9757
- Fax : (616) 457-8750
- Phone : (616) 457-4610
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207PE0004X | Emergency Medical Services | JL039848 | MI |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | JL039848 | MI |
| Y | 208D00000X | General Practice Physician | JL039848 | MI |
National Provider Identifier
| NPI | 1215059241 |
|---|---|
| Provider Name | Dr. Jay Allen Lugthart |
| First Address | Byron Center, MI 49315-9428 |
| Second Address | Jenison, MI 49428-9757 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/04/2007 |
| Last Update Date | 01/04/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0107011492 | BCBS (01) | |
| 114151PC | CCPPO, CHMO, MERCY HEALTH (01) | |
| 121787 | HEALR (01) | |
| 152756 | PHCS (01) | |
| 4099325 | AETNA (01) | |
| B44069 | (02) | |
| B44069 | PRIORITY HEALTH (01) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.