Roller, Jason R

Roller, Jason R is an individual health care provider with primary practice located at 3533 Southern Blvd Ste 2100, Kettering OH 45429-1267. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Roller, Jason R can be contacted via phone (937) 395-8556.

Contact Information

Primary practice address
3533 Southern Blvd Ste 2100 Kettering OH 45429-1267
Phone: (937) 395-8556
Fax: (937) 522-7873
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 50-002592 Ohio

Profile Details

NPI number 1689798662
LBN Legal business name Roller, Jason R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2007
Last updated Nov 24th, 2020 - about 5 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 1689798662 NPPES
Ohio MEDICAID 0080733

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