MEDICARE: JASON DREW SCHOFIELD 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	50.001394	OH
2	363A00000X	Physician Assistant	50001394	OH

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	:	1700806486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON DREW SCHOFIELD PA-C

Provider Business Mailing Address
First Line	:	425 W GRAND AVE STE 3003
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-4722
Country	:	US
Telephone Number	:	937-643-9299
Fax Number	:	937-643-2343

Provider Business Practice Location Address
First Line	:	425 W GRAND AVE STE 3003
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-4722
Country	:	US
Telephone Number	:	937-643-9299
Fax Number	:	937-643-2343

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	11/23/2020

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