Provider Demographics
NPI:1427426410
Name:MCADOO, JASON GLENN
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:GLENN
Last Name:MCADOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W PHELPS AVE
Mailing Address - Street 2:
Mailing Address - City:PIERCE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65723-1063
Mailing Address - Country:US
Mailing Address - Phone:417-669-0716
Mailing Address - Fax:
Practice Address - Street 1:111 S TREATY RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-5327
Practice Address - Country:US
Practice Address - Phone:918-540-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator