Individual
DR. JAY LEE SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
(517) 205-7346
Mailing address
4030 ZYGMUNT DR, JACKSON, MI 49201-8466
(505) 933-4629
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4351055214
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2025
Last updated
06/19/2025
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