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1619473204

NPI Code Detail

MEDICARE: DR. JASON W DAVID MD

MEDICARE: DR. JASON W DAVID MD

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
1	207P00000X	Emergency Medicine Physician	21143	NV
2	207P00000X	Emergency Medicine Physician	1026680	MA
3	207P00000X	Emergency Medicine Physician	2114	NV
4	207P00000X	Emergency Medicine Physician	32129	NE

General Provider Information

NPI Number	:	1619473204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON W DAVID MD

Provider Business Mailing Address
First Line	:	960 MASSACHUSETTS AVE STE 2
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-2690
Country	:	US
Telephone Number	:	617-414-4505
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 LAS VEGAS BLVD N
Second Line	:
City	:	NELLIS AFB
State	:	NV
Zip	:	89191-6600
Country	:	US
Telephone Number	:	702-653-2344
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	06/17/2026

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Directions to “ DR. JASON W DAVID MD” Practice Location

Language	Start Address	Practice Location

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