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NPI Code Detail

MEDICARE: JOHN JASON PAGE DO, PA

MEDICARE: JOHN JASON PAGE DO, PA
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
1207Q00000XFamily Medicine PhysicianL9838TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P01681642OTHERTXRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18FY021OTHERTXBCBS
2752616977118OTHERTXTRICARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376549246
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN JASON PAGE DO, PA
Provider Business Mailing Address
First Line : PO BOX 846098
Second Line :
City : DALLAS
State : TX
Zip : 75284-6098
Country : US
Telephone Number : 903-324-6400
Fax Number :
Provider Business Practice Location Address
First Line : 8288 S BROADWAY AVE
Second Line :
City : TYLER
State : TX
Zip : 75703-5262
Country : US
Telephone Number : 903-606-7060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 09/09/2016

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