Individual
JASON M CORLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-2432
Mailing address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-2432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.016171
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2021
Last updated
06/17/2024
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