Healthcare Provider Details

I. General information

NPI: 1871687707
Provider Name (Legal Business Name): JASON CORBEN WRIGHT P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4812 BLUFFTON PKWY
BLUFFTON SC
29910-4602
US

IV. Provider business mailing address

4812 BLUFFTON PKWY
BLUFFTON SC
29910-4602
US

V. Phone/Fax

Practice location:
  • Phone: 843-837-4300
  • Fax: 843-837-4304
Mailing address:
  • Phone: 843-837-4300
  • Fax: 843-837-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1388
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: