Provider Demographics
NPI:1659868909
Name:TRUITT, JAY MICHAEL (MD, PHD, PHARMD, MPH)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:MICHAEL
Last Name:TRUITT
Suffix:
Gender:M
Credentials:MD, PHD, PHARMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6102 82ND ST STE 15
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0840
Mailing Address - Country:US
Mailing Address - Phone:806-749-7933
Mailing Address - Fax:806-749-6117
Practice Address - Street 1:6102 82ND ST STE 15
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0840
Practice Address - Country:US
Practice Address - Phone:806-749-7933
Practice Address - Fax:806-749-6117
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-21
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
TX390200000X
TXV6415207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program