MEDICARE: JASON ASISTORES MD

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	207Q00000X	Family Medicine Physician	MT200875	PA
2	207Q00000X	Family Medicine Physician	0101258210	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649531401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ASISTORES MD

Provider Business Mailing Address
First Line	:	15 TERRY CT STE E
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-2568
Country	:	US
Telephone Number	:	540-328-2871
Fax Number	:	540-675-4004

Provider Business Practice Location Address
First Line	:	15 TERRY CT STE E
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-2568
Country	:	US
Telephone Number	:	540-328-2871
Fax Number	:	540-675-4004

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

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	09/27/2021

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