Healthcare Provider Details

I. General information

NPI: 1124125240
Provider Name (Legal Business Name): JASON D. GEORGE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 S WASHINGTON AVE
GREENSBURG PA
15601-2768
US

IV. Provider business mailing address

44 S WASHINGTON AVE
GREENSBURG PA
15601-2768
US

V. Phone/Fax

Practice location:
  • Phone: 724-261-5556
  • Fax: 724-689-0544
Mailing address:
  • Phone: 724-261-5556
  • Fax: 724-689-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA052615
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: