Individual
JASON TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1997 MIAMISBURG CENTERVILLE RD, DAYTON, OH 45459-3811
(800) 514-1494
Mailing address
6400 ATLANTIC BLVD, JACKSONVILLE, FL 32211-8768
(866) 638-5931
(904) 805-1456
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34008287
OH
Other
Enumeration date
08/21/2006
Last updated
07/09/2007
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