Individual
JASON LEE COSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1450 MATTHEWS TOWNSHIP PKWY STE 380, MATTHEWS, NC 28105
(704) 384-9200
(704) 384-6588
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9200
(704) 384-6588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06364
NC
363A00000X
Physician Assistant
008285
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02565520
—
NY
Enumeration date
10/02/2006
Last updated
10/26/2020
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