Individual
MR. JASON S URSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED PA
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-1430
(704) 403-1158
Mailing address
PO BOX 2000, CONCORD, NC 28026-2000
(704) 403-1430
(704) 403-1158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02122
NC
363AM0700X
Medical Physician Assistant
0010-02122
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5489L1
LEGACY
NY
Enumeration date
12/19/2005
Last updated
04/08/2022
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