Individual
JASON TYLER HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1650 COCHRANE CIR UNIT MEDDAC, FT CARSON, CO 80913-4604
(719) 526-7000
Mailing address
840 SWIFT CT, COLORADO SPRINGS, CO 80910-4312
(717) 606-9598
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0009729
CO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
03/02/2026
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