Individual
JAY ELLWORTH CHAMPLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5230 CENTRE AVE, PITTSBURGH, PA 15232-1304
(412) 623-2465
Mailing address
UW RADIOLOGY DEPT RR 210, 1959 N.E. PACIFIC STREET, BOX 357115, SEATTLE, WA 98195-7115
(206) 598-6483
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2019-0524
NM
2085R0204X
Vascular & Interventional Radiology Physician
MD2019-0524
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2013
Last updated
08/15/2019
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