Provider Demographics
NPI:1194301382
Name:MOOL, JASON LEE (PA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:LEE
Last Name:MOOL
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Gender:M
Credentials:PA
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Mailing Address - Street 1:650 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-4030
Mailing Address - Country:US
Mailing Address - Phone:785-239-4411
Mailing Address - Fax:630-570-5779
Practice Address - Street 1:650 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-4030
Practice Address - Country:US
Practice Address - Phone:785-239-4411
Practice Address - Fax:630-570-5779
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2022-01-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant