1154389286 NPI number — JASON FRANKLIN HAUSE DPT

Table of content: (NPI 1225027626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154389286 NPI number — JASON FRANKLIN HAUSE DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUSE
Provider First Name:
JASON
Provider Middle Name:
FRANKLIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154389286
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3421 CONCORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17402-9001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-812-5400
Provider Business Mailing Address Fax Number:
717-741-3598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
228 SAINT CHARLES WAY STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17402-4661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-812-5400
Provider Business Practice Location Address Fax Number:
717-741-3598
Provider Enumeration Date:
05/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT015792 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112121900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1022820270002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6863585 . This is a "CAREFIRST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1154389286 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50085190 . This is a "CBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1402397 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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