Provider Demographics
NPI:1124125240
Name:GEORGE, JASON D (PA-C)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:D
Last Name:GEORGE
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 1:44 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2768
Mailing Address - Country:US
Mailing Address - Phone:724-261-5556
Mailing Address - Fax:724-689-0544
Practice Address - Street 1:44 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2768
Practice Address - Country:US
Practice Address - Phone:724-261-5556
Practice Address - Fax:724-689-0544
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052615363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA286810Medicare PIN