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NPI Code Detail

MEDICARE: DR. JASON THOMAS HEDRICK M.D,

MEDICARE:  DR. JASON THOMAS HEDRICK  M.D,
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
1208600000XSurgery Physician208600000XOH

General Provider Information

NPI Number : 1417161753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON THOMAS HEDRICK M.D,
Provider Business Mailing Address
First Line : 9985 DAYTON LEBANON PIKE
Second Line :
City : CENTERVILLE
State : OH
Zip : 45458-4231
Country : US
Telephone Number : 937-305-5012
Fax Number : 937-886-9194
Provider Business Practice Location Address
First Line : 9985 DAYTON LEBANON PIKE
Second Line :
City : CENTERVILLE
State : OH
Zip : 45458-4231
Country : US
Telephone Number : 937-305-5012
Fax Number : 937-886-9194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 01/15/2016

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Directions to “ DR. JASON THOMAS HEDRICK M.D,” Practice Location

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