Provider Demographics
NPI:1851330807
Name:SZYMALA, JASON (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:SZYMALA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:EDWARD
Other - Last Name:SZYMALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3030
Mailing Address - Fax:412-359-3060
Practice Address - Street 1:40100 HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5906
Practice Address - Country:US
Practice Address - Phone:863-422-4971
Practice Address - Fax:863-419-2264
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0121043207R00000X
FLOS11750207R00000X
PAOS012643208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102497951Medicaid
MD410791800Medicaid
P00369822OtherRAILROAD MEDICARE
PA2524159OtherHIGHMARK BC/BS
PA102497951Medicaid
MDKP950180Medicare PIN
PA183783Medicare PIN