Hazelett, Jason

Hazelett, Jason is an individual health care provider with primary practice located at 5800 Fairfield Ave Ste 150 , Fort Wayne IN 46807-3450. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Hazelett, Jason can be contacted via phone (260) 744-5585.

Contact Information

Primary practice address
5800 Fairfield Ave Ste 150 Fort Wayne IN 46807-3450
Phone: (260) 744-5585
Fax: (260) 744-5586
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05006433A Indiana

Profile Details

NPI number 1346247681
LBN Legal business name Hazelett, Jason
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Nov 21st, 2008 - about 18 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 1346247681 NPPES
Indiana MEDICAID 200195670
Indiana Other P002239911

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