MR. JAY HANSON WRUCK


Address: 4318 Edgewater Dr Nw, Kennesaw, GA 30144-5170
Phone: 7705921580

MR. JAY HANSON WRUCK (NPI# 1437465614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437465614
Entity Type Individual
Full Name MR. JAY HANSON WRUCK
Credential C.O.M.A./C.P.P.
Practice Address 4318 Edgewater Dr Nw
Kennesaw
GA 30144-5170
Practice Telephone 7705921580
Mailing Telephone 7705921580
Enumeration Date 2010-08-25
Last Update Date 2010-08-25
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 156F00000X Technician/Technologist 2010#65900 GA Eye and Vision Services Providers

Office Location

Street Address 4318 EDGEWATER DR NW
City KENNESAW
State GA
Zip Code 30144-5170

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1851745988 Joseph Mulligan Social Worker 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 2016-04-14
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Taxonomy Information

Taxonomy Code 156F00000X
Grouping Eye and Vision Services Providers
Classification Technician/Technologist

Taxonomy Definition

A broad category grouping different kinds of technologists and technicians. See individual definitions.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346849809 Jalyn Calloway Technician/Technologist 3655 Howell Ferry Rd Ste 400, Duluth, GA 30096-3186 2020-10-25
1003423153 Rochelle Wyche Technician/Technologist 4920 Roswell Rd Ste 1, Atlanta, GA 30342-2684 2020-09-23
1952925869 Carolyn White Technician/Technologist 2147 Silver Thorn Ct, Lithonia, GA 30058-3585 2020-06-05
1760004584 Kevin John Weiner Technician/Technologist 3301 Buckeye Rd Ste 700, Atlanta, GA 30341-4236 2020-05-14
1568082535 Shemeka Brownlee Technician/Technologist 2773 Spirit Creek Rd, Hephzibah, GA 30815-5985 2020-04-20
1558864710 Michelle Osborne Technician/Technologist 1520 E Water St, Bainbridge, GA 39817-4262 2018-03-14
1376059865 Lachaun Serena Harper Technician/Technologist 5825 Glenridge Dr Ste 101, Atlanta, GA 30328-5387 2017-12-19
1538678255 Natalie Mckay Technician/Technologist 3915 Cascade Rd, 220, Atlanta, GA 30331 2017-09-26
1801052311 Kwan Ha Lee Technician/Technologist 2442 Pleasant Hill Road, Suite 4, Duluth, GA 30096-1700 2008-08-04
1326677600 Chari Lakey Technician/Technologist 1405 Clifton Rd Ne, Atlanta, GA 30322-3050 2020-04-07
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Competitor

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City KENNESAW
Zip Code 30144

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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