Individual
MR. JASON ERIC SEYMOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5 EXECUTIVE CIR, SAVANNAH, GA 31406-3345
(912) 355-2400
(912) 355-5324
Mailing address
103 WINDING ROAD, DIPRETA DERMATOLOGY, BRUNSWICK, GA 31525
(912) 510-7546
(912) 510-7550
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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