Basic Information
| Provider Information | |||||||||
| NPI: | 1366577942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRATECHAUD | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 E. MICHIGAN AVE. | ||||||||
| Address2: | SUITE 370 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489121897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174844451 | ||||||||
| FaxNumber: | 5174840291 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 E. MICHIGAN AVE. | ||||||||
| Address2: | SUITE 370 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489121897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174844451 | ||||||||
| FaxNumber: | 5174840291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2007 | ||||||||
| LastUpdateDate: | 08/11/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 5101015596 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.