Provider Demographics
NPI:1104939230
Name:HARPER, JASON LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:LOUIS
Last Name:HARPER
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 1:235 TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4544
Mailing Address - Country:US
Mailing Address - Phone:731-644-3211
Mailing Address - Fax:731-644-1552
Practice Address - Street 1:235 TYSON AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4544
Practice Address - Country:US
Practice Address - Phone:731-644-3211
Practice Address - Fax:731-644-1552
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41551208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN40747OtherTLC FAMILY CARE HEALTHPLA
TN4154739OtherBLUE CROSS BLUE SHIELD OF TENNESSEE
TNDB4003OtherRAILROAD MEDICARE GROUP NUMBER
TNP00446973OtherRAILROAD MEDICARE INDIVIDUAL NUMBER
TN3822244OtherMEDICARE INDIVIDUAL NUMBER
TN3822244Medicaid
TN3822244OtherMEDICARE INDIVIDUAL NUMBER
TN3724040Medicare PIN