Provider Demographics
NPI:1538293279
Name:HANDLER, JASON PAUL (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:PAUL
Last Name:HANDLER
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 1:201 LEPHILLIP COURT, NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2900
Mailing Address - Country:US
Mailing Address - Phone:704-782-1127
Mailing Address - Fax:704-782-1207
Practice Address - Street 1:201 LEPHILLIP COURT, NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2900
Practice Address - Country:US
Practice Address - Phone:704-782-1127
Practice Address - Fax:704-782-1207
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL 27940207W00000X
NC200900527207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5912404OtherMEDICAID
NC153EPOtherBLUE CROSS BLUE SHIELD OF NC
NC5912404OtherMEDICAID