Individual
JASON RODWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6000
Mailing address
1431 CENTERPOINT BLVD, KNOXVILLE, TN 37932-1984
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004881
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256378633A
—
GA
05
—
256378633B
—
GA
01
—
P00360970
RAILROAD MEDICARE
GA
Enumeration date
09/22/2006
Last updated
03/07/2008
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