Fontan, Jason

Fontan, Jason is an individual health care provider with primary practice located at 2809 Denny Ave , Pascagoula MS 39581-5301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fontan, Jason can be contacted via phone (228) 809-5510.

Contact Information

Primary practice address
2809 Denny Ave Pascagoula MS 39581-5301
Phone: (228) 809-5510
Fax: (228) 809-5519
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MS17948 Mississippi

Profile Details

NPI number 1124170451
LBN Legal business name Fontan, Jason
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Mar 4th, 2014 - about 12 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 1124170451 NPPES
Other 646000515E BLUE CROSS OF MS
MEDICAID 009944055 BLUE CROSS OF MS
Other P00054446 BLUE CROSS OF MS
MEDICAID JF09280201 BLUE CROSS OF MS

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