=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578725602
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JASON J. CLARITY, D.O.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2008
-----------------------------------------------------
Last Update Date | 01/30/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24 S LEHIGH AVE
-----------------------------------------------------
City | FRACKVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17931-1816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-874-3620
-----------------------------------------------------
Fax | 570-874-3980
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24 S LEHIGH AVE
-----------------------------------------------------
City | FRACKVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17931-1816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-874-3620
-----------------------------------------------------
Fax | 570-874-3980
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE PROPRIETER
-----------------------------------------------------
Name | DR. JASON JOHN CLARITY
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 570-874-3620
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | OS015677
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | 0S015677
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------