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Individual

DR. JASON W EDSALL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
830 ROCKFORD ST, EMERGENCY DEPARTMENT, MT AIRY, NC 27030-5322
(336) 786-6068
Mailing address
PO BOX 900035, ATTN LISA BROWER, RALEIGH, NC 27675-9035

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101242157
VA
207P00000X
Emergency Medicine Physician
Primary
200101331
NC
207P00000X
Emergency Medicine Physician
Primary
NC
207Q00000X
Family Medicine Physician
0101242157
VA
207R00000X
Internal Medicine Physician
0101242157
VA
208000000X
Pediatrics Physician
0101242157
VA
208100000X
Physical Medicine & Rehabilitation Physician
0101242157
VA
2085R0202X
Diagnostic Radiology Physician
0101242157
VA
208600000X
Surgery Physician
0101242157
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891356E6
NC
Enumeration date
12/07/2005
Last updated
04/24/2026
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