Provider Demographics
NPI:1639384720
Name:HEDGES, JASON CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:CHARLES
Last Name:HEDGES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD # L588
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-8311
Mailing Address - Fax:503-494-8671
Practice Address - Street 1:3303 SW BOND AVE
Practice Address - Street 2:CH10U
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-494-8311
Practice Address - Fax:503-494-8671
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORLL16049208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology