Individual
MR. JASON ERIC SEYMOUR
Active
Individual
MR. JASON ERIC SEYMOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003481
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01158096
AMERIGROUP
GA
05
—
100001610E
—
GA
05
—
100001610F
—
GA
Enumeration date
05/03/2006
Last updated
11/22/2017
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