Individual
MR. JASON STEWART DANIEL HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 774-5592
Mailing address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
928-L
MS
207R00000X
Internal Medicine Physician
98879
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
98879
GA
207RP1001X
Pulmonary Disease Physician
98879
GA
207RP1001X
Pulmonary Disease Physician
MD23398
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01378761
—
MS
Enumeration date
05/20/2014
Last updated
07/11/2024
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