Port, Jason L.
Port, Jason L. is an sole proprietor health care provider with primary practice located at 3640 Main St Suite 101, Springfield MA 01107-1145. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neuroradiology, which is considered as his primary health care specialty. Port, Jason L. can be contacted via phone (413) 781-9000.Contact Information
Primary practice address
3640 Main St Suite 101
Springfield MA 01107-1145
Phone: (413) 781-9000
Fax: (413) 781-7988
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 151546 | Massachusetts |
Profile Details
| NPI number | 1114033396 |
|---|---|
| LBN Legal business name | Port, Jason L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Jul 8th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114033396 | NPPES |
| Massachusetts | MEDICAID | 3154656 | |
| Massachusetts | Other | J16771 |
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