Provider Demographics
NPI:1578651949
Name:DOTSON, JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:DOTSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-2911
Mailing Address - Country:US
Mailing Address - Phone:706-695-7790
Mailing Address - Fax:706-695-9003
Practice Address - Street 1:720 S GLENWOOD AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-3389
Practice Address - Country:US
Practice Address - Phone:706-259-5599
Practice Address - Fax:706-259-9848
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHLZMedicare ID - Type UnspecifiedMEDICARE ID
GAU97299Medicare UPIN