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NPI Code Detail

MEDICARE: JASON K AUSTIN D.O

MEDICARE:   JASON K AUSTIN  D.O
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDO00660RI

General Provider Information

NPI Number : 1013963818
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON K AUSTIN D.O
Provider Business Mailing Address
First Line : 1524 ATWOOD AVENUE SUITE 220
Second Line :
City : JOHNSTON
State : RI
Zip : 02919
Country : US
Telephone Number : 401-272-1900
Fax Number : 401-453-3049
Provider Business Practice Location Address
First Line : 1524 ATWOOD AVE STE 220
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-3278
Country : US
Telephone Number : 401-272-1900
Fax Number : 401-453-3049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 11/26/2019

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