Individual
JASON EDWARD BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1000
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT212122
PA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
S6570
TX
208M00000X
Hospitalist Physician
S6570
TX
Other
Enumeration date
06/24/2016
Last updated
12/03/2021
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