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General NPI Number Information
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NPI Number | 1508783507
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Entity Type | Individual
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Provider Name | JASON JASON TIEDEMANN PARAMEDIC
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Gender | Male
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 304 TURNER MCCALL BLVD SW
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City | ROME
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State | GA
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Zip | 30165-5621
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Country | US
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Telephone | 706-509-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 51 ROBERTS CHAPEL RD
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City | PIEDMONT
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State | AL
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Zip | 36272-6939
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Country | US
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Telephone | 256-913-6580
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 0100679
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License Number State | AL
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