Healthcare Provider Details

I. General information

NPI: 1285020545
Provider Name (Legal Business Name): JASON GAGNON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 E WASHINGTON ST
NORTH ATTLEBORO MA
02760-2312
US

IV. Provider business mailing address

153 E WASHINGTON ST
NORTH ATTLEBORO MA
02760-2312
US

V. Phone/Fax

Practice location:
  • Phone: 508-406-7423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number284023
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: