# DR. JASON D RUPP

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164797270
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 10392993-1205 | UT | — |
| 207W00000X | Ophthalmology Physician | 2016010391 | MO | Yes |

## Other

- **Enumeration date:** 03/22/2012
- **Last updated:** 10/09/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1164797270 | — | IL |
| 05 | — | 1164797270 | — | MO |