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Individual

DR. JASON MCCOURT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2700 UNIVERSITY SQUARE DR, TAMPA, FL 33612
(813) 253-2721
(813) 253-2299
Mailing address
350 W THOMAS RD, ATTN: ACADEMIC AFFAIRS, PHOENIX, AZ 85013-4409
(602) 406-3382

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R74074
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
ME134589
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R74074
TRAINING PERMIT
AZ
Enumeration date
06/19/2013
Last updated
06/25/2018
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