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Individual

MR. JASON SHAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3800 S NATIONAL AVE STE 510, SPRINGFIELD, MO 65807-5284
(417) 875-3114
(417) 875-3922
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085003699
IL
363A00000X
Physician Assistant
Primary
2017027196
MO
363A00000X
Physician Assistant
PA9106343
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013231950
MO
05
220045444
MO
Enumeration date
03/22/2010
Last updated
12/27/2018
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