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General NPI Number Information
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NPI Number | 1275952590
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Entity Type | Individual
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Provider Name | JASON LO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 351 WELLESLEY TRADE LN STE 100
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City | CARY
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State | NC
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Zip | 27519-5669
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Country | US
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Telephone | 919-576-8100
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Fax | 614-293-4980
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Provider Business Mailing Address
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Address Line | 4023 ROBIOUS CT
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City | CARY
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State | NC
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Zip | 27519-7325
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Country | US
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Telephone | 910-302-8618
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.145317
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.145317
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 250215
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License Number State | NC
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