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General NPI Number Information
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NPI Number | 1518914290
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Entity Type | Individual
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Provider Name | JASON PEARCE BEISSINGER PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 2001 CRYSTAL SPRING AVE SW
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City | ROANOKE
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State | VA
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Zip | 24014-2462
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Country | US
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Telephone | 540-853-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA156566
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0479
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60485011
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110002807
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License Number State | VA
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