Provider Demographics
NPI:1952632937
Name:ADAMS, JASON DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:DAVID
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 CARRIAGE CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2945
Mailing Address - Country:US
Mailing Address - Phone:910-261-0065
Mailing Address - Fax:
Practice Address - Street 1:5397 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1417
Practice Address - Country:US
Practice Address - Phone:910-488-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant