Jason R Southall PA-C

NPI 1316117930 - Physician Assistant - 363A00000X

NPI Details
NPI 1316117930
Gender Male
Enumeration Date 03/11/2008
Last Updated 09/18/2009
Entity Type Individual
Active Over 8 years ago
Practice Location
2 STONECREST DR
HUNTINGTON WV, 25701-9391, US
Phone (304) 525-2273
Fax (304) 525-1148
Business Location
2 STONECREST DR
HUNTINGTON WV, 25701-9391, US
Phone (304) 525-2273
Fax (304) 525-1148
Toxanomy
Taxonomy Code 363A00000X
License State West Virginia
License Number 01257
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According to our database, Mr. Jason R Southall PA-C NPI is 1316117930, taxonomy code is 363A00000X and license number is 01257, license state is located at West Virginia. Jason R Southall PA-C physically located at 2 Stonecrest Dr, Huntington WV, 25701-9391. NPI Number Jason R Southall PA-C has the Individual type.

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1316117930 NPI number is provided on an as is basis without warranty of any kind. 1316117930 is maintained by the National Plan & Provider Enumeration System. The contents of Jason R Southall PA-C are for informational purposes only.