# JASON A TATE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336647577
- **Authorized official:** DIANNE TATE (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (410) 756-9110

## Contact information

- **Practice address:** 76 FREDERICK ST, TANEYTOWN, MD 21787-2135
- **Practice address phone:** (410) 756-9110
- **Mailing address:** PO BOX 973, WESTMINSTER, MD 21158-0973
- **Mailing address phone:** (410) 848-5785
- **Mailing address fax:** (410) 848-5629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2018
- **Last updated:** 01/23/2018