Individual
DR. JASON R VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7586 CATCHFLY DR, OOLTEWAH, TN 37363-1725
(530) 966-5454
(530) 872-6653
Mailing address
7586 CATCHFLY DR, OOLTEWAH, TN 37363-1725
(530) 966-5454
(530) 872-6653
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A60594
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ01920Z
BLUE SHIELD
CA
Enumeration date
07/05/2006
Last updated
07/14/2022
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