Provider Demographics
NPI:1063278349
Name:BARON, JASON RAYMOND (PRSS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:RAYMOND
Last Name:BARON
Suffix:
Gender:M
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E SENNA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-7536
Mailing Address - Country:US
Mailing Address - Phone:602-510-1711
Mailing Address - Fax:
Practice Address - Street 1:324 E SENNA WAY
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-7536
Practice Address - Country:US
Practice Address - Phone:602-510-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist