Individual
DR. JASON A CRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 960-4586
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 949-9106
(601) 914-1835
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
19184
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00624501
—
MS
01
—
1184753485
NPI
MS
01
—
512G700003
UP MEDICARE PTAN
—
01
—
512I200016
M'CARE PTAN
MS
01
—
P00619788
RAILROAD MEDICARE PTAN
MS
01
—
P00621369
RAILROAD MEDICARE PTAN-GROUP#CC1164
MS
Enumeration date
03/04/2007
Last updated
02/11/2013
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