Provider Demographics
NPI:1568575496
Name:SALTER, JASON D (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:D
Last Name:SALTER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2002
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:STE 1004
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-973-9600
Practice Address - Fax:508-973-9605
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-04-27
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Provider Licenses
StateLicense IDTaxonomies
MA252725207Q00000X, 207Q00000X
RIDO00646207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110094165AMedicaid
MA002916001Medicare PIN