Mcintosh, Jason Joseph

Mcintosh, Jason Joseph is an individual health care provider with primary practice located at 256 Sw Professional Gln , Lake City FL 32025-1104. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Mcintosh, Jason Joseph can be contacted via phone (386) 758-8937.

Contact Information

Primary practice address
256 Sw Professional Gln Lake City FL 32025-1104
Phone: (386) 758-8937
Fax: (386) 755-2169
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP9172755 Florida

Profile Details

NPI number 1720040967
LBN Legal business name Mcintosh, Jason Joseph
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jul 28th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720040967 NPPES
Georgia MEDICAID 552391106A
Georgia Other G3954
Georgia MEDICAID 3074935-00
Georgia Other P00326148

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