Provider Demographics
NPI:1831122761
Name:BELAND, JASON CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:CHRISTOPHER
Last Name:BELAND
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 1:600 PARKWAY NORTH
Mailing Address - Street 2:CANCER TREATMENT CENTERS OF AMERICA
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265
Mailing Address - Country:US
Mailing Address - Phone:404-250-6797
Mailing Address - Fax:404-256-3271
Practice Address - Street 1:600 PARKWAY NORTH
Practice Address - Street 2:CANCER TREATMENT CENTERS OF AMERICA
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265
Practice Address - Country:US
Practice Address - Phone:770-400-6000
Practice Address - Fax:404-256-3271
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55920174400000X, 2085R0202X
NC200401172174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA759854446AMedicaid
GAI51918Medicare UPIN
GA30BDMVMMedicare ID - Type UnspecifiedATL RADIOLOGY