MEDICARE: JASON COREY JONES PA-C

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	363AM0700X	Medical Physician Assistant	MA0560872	PA

General Provider Information

NPI Number	:	1629037106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON COREY JONES PA-C

Provider Business Mailing Address
First Line	:	3624 MARKET ST
Second Line	:	SUITE 560W
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2614
Country	:	US
Telephone Number	:	215-662-2286
Fax Number	:	215-615-0500

Provider Business Practice Location Address
First Line	:	250 KING OF PRUSSIA RD
Second Line	:
City	:	RADNOR
State	:	PA
Zip	:	19087-5220
Country	:	US
Telephone Number	:	610-902-2500
Fax Number	:

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	10/26/2007

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