Provider Demographics
NPI:1780824300
Name:AINES, JASON M (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:AINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 626
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005
Mailing Address - Country:US
Mailing Address - Phone:207-294-5000
Mailing Address - Fax:207-294-5505
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-294-5000
Practice Address - Fax:207-294-5055
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-22
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188759207P00000X
ME018197207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001175401Medicare UPIN