# MR. JASON ROBERT DERRINGTON

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

## Provider details

- **NPI number:** 1912532375
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 47-4307900 | IN | — |
| 2081P0004X | Spinal Cord Injury Medicine Physician | 47-4307900 | IN | Yes |

## Other

- **Enumeration date:** 03/06/2020
- **Last updated:** 03/06/2020