Provider Demographics
NPI:1902905946
Name:LUMSDON, JAY CARTER (DC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:CARTER
Last Name:LUMSDON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-1239
Mailing Address - Country:US
Mailing Address - Phone:317-738-2300
Mailing Address - Fax:317-738-0011
Practice Address - Street 1:925 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-1239
Practice Address - Country:US
Practice Address - Phone:317-738-2300
Practice Address - Fax:317-738-0011
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000490A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
431550Medicare ID - Type Unspecified