Individual
JASON H MILDENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2800 CLAY EDWARDS DR, NORTH KANSAS CITY, MO 64116
(816) 691-2000
Mailing address
5665 NEW NORTHSIDE DR, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-5468
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007036
GA
363A00000X
Physician Assistant
Primary
2018011301
MO
Other
Enumeration date
09/27/2013
Last updated
07/17/2018
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