Provider Demographics
NPI:1265643738
Name:VELEZ, JASON WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:WILLIAM
Last Name:VELEZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1285 HEMBREE RD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5720
Mailing Address - Country:US
Mailing Address - Phone:770-475-2710
Mailing Address - Fax:770-360-0498
Practice Address - Street 1:1285 HEMBREE RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5720
Practice Address - Country:US
Practice Address - Phone:770-475-2710
Practice Address - Fax:770-360-0498
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2017-03-29
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Provider Licenses
StateLicense IDTaxonomies
GA064486207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA455299076AMedicaid
GA455299076CMedicaid
GA202I206125Medicare PIN