Ford, Jason

Ford, Jason is an individual health care provider with primary practice located at 31 N Saint Joseph Ave , Niles MI 49120. 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. Ford, Jason can be contacted via phone (269) 687-1879.

Contact Information

Primary practice address
31 N Saint Joseph Ave Niles MI 49120
Phone: (269) 687-1879
Fax: (269) 683-0104
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28165863 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704267914 Michigan

Profile Details

NPI number 1063463933
LBN Legal business name Ford, Jason
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Jun 24th, 2024 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1063463933 NPPES
Indiana MEDICAID 200539770

Popular Providers