Basic Information
| Provider Information | |||||||||
| NPI: | 1275739922 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIVEN | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | TYLER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2450 INDIA HOOK RD | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297323270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033667443 | ||||||||
| FaxNumber: | 8033291118 | ||||||||
| Practice Location | |||||||||
| Address1: | 1393 CELANESE RD | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297321722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033293103 | ||||||||
| FaxNumber: | 8033252232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 05/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 29732 | SC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.