Individual
JASON KYLE HONAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
257 HOSPITAL DR., SUITE 101, BOLIVIA, NC 28422-8411
(910) 721-4100
(910) 721-4101
Mailing address
PO BOX 60447, SUITE 4K, CHARLOTTE, NC 28260-0447
(910) 721-4100
(910) 721-4101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05410
NC
363A00000X
Physician Assistant
0110002364
VA
363A00000X
Physician Assistant
014724
NY
Other
Enumeration date
03/06/2007
Last updated
02/01/2024
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