Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JAY RUSSELL WAITE, IDC
ActiveMR. JAY RUSSELL WAITE, IDC is a Independent Duty Corpsman healthcare provider located in FALLON, Nevada. NPI 1114064789 is currently active in the NPPES registry. Verify at CMS.
Independent Duty Corpsman · FALLON, NV
Registration Details
- NPI Number
- 1114064789
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 31, 2007 (19.390035457419 yrs)
- Last Updated
- Jul 8, 2007
Practice Information
- Address
-
4755 PASTURE RDFALLON, NV, 894965000Browse NV providers · Browse ZIP 89496
- Phone
- 7754263130
- Fax
- 7754263133
- Primary Specialty
-
Independent Duty Corpsman
1710I1002X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.