Individual
JASON LEE THARPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
194 HOWARD ST, NEW LONDON, CT 06320-5544
(860) 442-0564
Mailing address
PO BOX 759047, BALTIMORE, MD 21275-9047
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0002995
VA
363AS0400X
Surgical Physician Assistant
Primary
3027
CT
Other
Enumeration date
06/07/2006
Last updated
07/22/2020
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