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NPI Code Detail

MEDICARE: MR. JASON EUGENE JAMES

MEDICARE: MR. JASON EUGENE JAMES
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
1171000000XMilitary Health Care Provider
2363A00000XPhysician Assistant1082443VA
3363A00000XPhysician Assistant0110003800VA

General Provider Information

NPI Number : 1639154503
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON EUGENE JAMES
Provider Business Mailing Address
First Line : 5000 COX RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-9263
Country : US
Telephone Number : 804-968-5700
Fax Number :
Provider Business Practice Location Address
First Line : 3370 PUMP RD
Second Line :
City : RICHMOND
State : VA
Zip : 23233-1130
Country : US
Telephone Number : 804-360-8061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 05/09/2019

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