Jason Downard

Individual provider Active NPI Physical Therapy Assistant · Hazlehurst, MS

NPI 1346563558 · NPPES record last updated Mar 3, 2010

Key facts

NPI
1346563558
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA4424 (MS)
Practice address
133 W Gallatin St
Hazlehurst, MS 39083-3020
Phone
(601) 894-2027
NPI assigned
Mar 3, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA4424MSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA4424 MS Yes

Addresses

Primary practice location

133 W Gallatin St
Hazlehurst, MS 39083-3020

Mailing address

4109 Highway 98 W
Summit, MS 39666-9132

Other providers in Hazlehurst, MS

All providers in Hazlehurst, MS · Physical Therapy Assistant in Mississippi

Sources for this page

Verify at the official NPI Registry.