Individual
DR. JAY ALLEN DIRKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6600 EXCELSIOR BLVD STE 160, ST LOUIS PARK, MN 55426
(952) 993-7700
Mailing address
6600 EXCELSIOR BLVD STE 160, ST LOUIS PARK, MN 55426-4713
(952) 993-7700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0113366
MEDICA
MN
01
—
1029313
PREFERRED ONE
MN
05
—
116678600
—
MN
01
—
171376
UCARE MN
MN
01
—
1796988
AMERICA'S PPO
MN
01
—
256R4DI
BCBS OF MN
MN
01
—
6605843
MEDICA UC
MN
01
—
7402476
AETNA
MN
01
—
HP38689
HEALTHPARTNERS
MN
Enumeration date
04/08/2006
Last updated
11/21/2019
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