Provider Demographics
NPI:1750523643
Name:HANKS, JASON DELL (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:DELL
Last Name:HANKS
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 1:5528 HOWE ST
Mailing Address - Street 2:APT 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2343
Mailing Address - Country:US
Mailing Address - Phone:925-858-1643
Mailing Address - Fax:
Practice Address - Street 1:5528 HOWE ST
Practice Address - Street 2:APT 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-2343
Practice Address - Country:US
Practice Address - Phone:925-858-1643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA122814207L00000X
PAMD446892207L00000X
ILMT201401207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program