Individual
JASON GORDON MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, BOX 697, ROCHESTER, NY 14642
(585) 275-2222
Mailing address
601 ELMWOOD AVE, BOX 697, ROCHESTER, NY 14642-0001
(585) 275-2222
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
10814701-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2014
Last updated
11/20/2021
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