Provider Demographics
NPI:1710956743
Name:TRUITT, JASON RANDALL (HS2/EMT-B/IDHS/LSM)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:RANDALL
Last Name:TRUITT
Suffix:
Gender:M
Credentials:HS2/EMT-B/IDHS/LSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USCG HQ COMDT (CG-1122) 2100 SECOND ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:202-475-5181
Mailing Address - Fax:202-472-5909
Practice Address - Street 1:USCG HQ COMDT (CG-1122) 2100 SECOND ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:202-475-5909
Practice Address - Fax:202-475-5909
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other