Provider Demographics
NPI:1902689391
Name:THOMAS, JASON ALLEN
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ALLEN
Last Name:THOMAS
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 1:43422 W OAKS DRIVE STE 191
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377
Mailing Address - Country:US
Mailing Address - Phone:234-567-3133
Mailing Address - Fax:
Practice Address - Street 1:43422 W OAKS DRIVE STE 191
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377
Practice Address - Country:US
Practice Address - Phone:866-766-3783
Practice Address - Fax:248-254-6524
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic