Provider Demographics
NPI:1932423381
Name:PACE, JASON FRANK (PA)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:FRANK
Last Name:PACE
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:2451 S WHITE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-7306
Mailing Address - Country:US
Mailing Address - Phone:928-532-7599
Mailing Address - Fax:928-532-8599
Practice Address - Street 1:2451 S WHITE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7306
Practice Address - Country:US
Practice Address - Phone:928-532-7599
Practice Address - Fax:928-532-8599
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ5922363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical