Healthcare Provider Details

I. General information

NPI: 1689644825
Provider Name (Legal Business Name): RONALD L JASPER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 HOSPITAL RD
INDIANA PA
15701-3629
US

IV. Provider business mailing address

1699 WASHINGTON RD STE 307
PITTSBURGH PA
15228-1629
US

V. Phone/Fax

Practice location:
  • Phone: 724-357-7000
  • Fax:
Mailing address:
  • Phone: 412-831-3744
  • Fax: 412-831-5663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS00722AL
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: