Provider Demographics
NPI:1013963818
Name:AUSTIN, JASON K (DO)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:K
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1524 ATWOOD AVENUE SUITE 220
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-272-1900
Mailing Address - Fax:401-453-3049
Practice Address - Street 1:1524 ATWOOD AVE STE 220
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3278
Practice Address - Country:US
Practice Address - Phone:401-272-1900
Practice Address - Fax:401-453-3049
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2019-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIDO00660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H22697Medicare UPIN