MEDICARE: MR. JASON CORBEN WRIGHT P.A.

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	363AM0700X	Medical Physician Assistant	PA335	KY
2	363AM0700X	Medical Physician Assistant	1388	SC
3	363A00000X	Physician Assistant	1388	SC

General Provider Information

NPI Number	:	1871687707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON CORBEN WRIGHT P.A.

Provider Business Mailing Address
First Line	:	989 RIBAUT RD
Second Line	:	SUITE 260
City	:	BEAUFORT
State	:	SC
Zip	:	29902-5472
Country	:	US
Telephone Number	:	843-522-7600
Fax Number	:	843-522-7612

Provider Business Practice Location Address
First Line	:	845 WILLIAM HILTON PKWY
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29928-3404
Country	:	US
Telephone Number	:	843-341-2416
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/03/2025

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