Healthcare Provider Details

I. General information

NPI: 1760819023
Provider Name (Legal Business Name): JASON ANDREW HOSKINS PT, DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3103 PURCELL RD
PARAGOULD AR
72450-8734
US

IV. Provider business mailing address

806 GLENDALE ST
JONESBORO AR
72401-4455
US

V. Phone/Fax

Practice location:
  • Phone: 870-565-3397
  • Fax:
Mailing address:
  • Phone: 870-933-9528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: