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NPI Code Detail

MEDICARE: JASON SCOTT WHIGHAM PT

MEDICARE: JASON SCOTT WHIGHAM PT
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
1225100000XPhysical Therapist16034MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17574763OTHERMAAETA PIN
23322108OTHERMAAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
49306424OTHERMAPHCS
5Y68255OTHERMABCBS

General Provider Information

NPI Number : 1407821556
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON SCOTT WHIGHAM PT
Provider Business Mailing Address
First Line : 63 WINTHROP LN
Second Line :
City : HOLDEN
State : MA
Zip : 01520-2540
Country : US
Telephone Number : 508-864-6205
Fax Number :
Provider Business Practice Location Address
First Line : 319A SOUTHBRIDGE ST
Second Line :
City : AUBURN
State : MA
Zip : 01501-2598
Country : US
Telephone Number : 508-832-2628
Fax Number : 508-832-4099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 01/03/2024

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