Provider Demographics
NPI:1326008566
Name:SPERRY, JASON LEE (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:LEE
Last Name:SPERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST.
Mailing Address - Street 2:SUITE F 1268 UPMC, PRESBYTERIAN,
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-692-2850
Mailing Address - Fax:412-648-6872
Practice Address - Street 1:200 LOTHROP ST.
Practice Address - Street 2:SUITE F 1268 UPMC, PRESBYTERIAN,
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-692-2850
Practice Address - Fax:412-648-6872
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4312252086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173893201Medicaid
H04656Medicare UPIN
TXSP08D5922Medicare ID - Type Unspecified