MEDICARE: MR. JASON ALAN SNOW PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	003	VI

General Provider Information

NPI Number	:	1366404501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON ALAN SNOW PA-C

Provider Business Mailing Address
First Line	:	4100 SION FARM SHOPP CTR STE 5
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4433
Country	:	US
Telephone Number	:	340-513-7801
Fax Number	:	340-713-7001

Provider Business Practice Location Address
First Line	:	4100 SION FARM SHOPP CTR STE 5
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4433
Country	:	US
Telephone Number	:	340-513-7801
Fax Number	:	340-713-7001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	08/15/2013

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