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Individual

DR. JASON MATTHEW JERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
35 MEMORIAL DR, PINEHURST, NC 28374-8708
(910) 715-3376
Mailing address
35 MEMORIAL DR, PINEHURST, NC 28374-8708
(910) 715-3376

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
2016-02570
NC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
ME86759
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023284353
NC
05
3065454
OH
Enumeration date
05/06/2008
Last updated
05/09/2017
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