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NPI Code Detail

MEDICARE: DR. JASON WALGOS DNP

MEDICARE: DR. JASON WALGOS DNP
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
1367500000XCertified Registered Nurse Anesthetist163695NC

General Provider Information

NPI Number : 1861959579
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON WALGOS DNP
Provider Business Mailing Address
First Line : 2430 EMERALD PL STE 201
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-5743
Country : US
Telephone Number : 252-752-2140
Fax Number :
Provider Business Practice Location Address
First Line : 2430 EMERALD PL STE 201
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-5743
Country : US
Telephone Number : 252-752-2140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2019
Last Update Date : 02/09/2026

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