Individual
JASON E. SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
927 BROADWAY ST, QUINCY, IL 62301-2719
(217) 223-8400
Mailing address
927 BROADWAY ST, QUINCY, IL 62301-2719
(217) 223-8400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-114538
IL
207Q00000X
Family Medicine Physician
Primary
036-114538
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-114538
STATE MEDICAL LICENSE
IL
Enumeration date
06/28/2006
Last updated
08/15/2013
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