Provider Demographics
NPI:1942994595
Name:THOMAS, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 LIGHT HALL 2215 GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0685
Mailing Address - Country:US
Mailing Address - Phone:615-322-7821
Mailing Address - Fax:615-343-1496
Practice Address - Street 1:303 LIGHT HALL 2215 GARLAND AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0685
Practice Address - Country:US
Practice Address - Phone:615-322-7821
Practice Address - Fax:615-343-1496
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program