Provider Demographics
NPI:1568443430
Name:ROWLES, JASON C (PA)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:ROWLES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4738
Mailing Address - Country:US
Mailing Address - Phone:781-934-2400
Mailing Address - Fax:781-934-5640
Practice Address - Street 1:95 TREMONT ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4738
Practice Address - Country:US
Practice Address - Phone:781-934-2400
Practice Address - Fax:781-934-5640
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
B47111Medicare ID - Type Unspecified
D88138Medicare UPIN