Male or Other

Mr. Jason G. Lunsford PA-C

Physician Assistant in Gulf Breeze, FL(View on Map)

Full Name

Mr. Jason Gary Lunsford PA-C

NPI Number

1679628556

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/24/2007

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA9108485

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 30532
1040 GULF BREEZE PKWY

City

Pensacola
Gulf Breeze

State

FL
FL

Postal Code

32503-1532
32561-7809

Country

US
US

Telephone Number

(850) 478-1312
(850) 916-3700

Identifiers

Identifier

Y0R57
172374
014787900
593-16867

Identifier State

FL
AL
FL
AL

Identifier Issuer

BLUE CROSS BLUE SHIELD
Unknown
Unknown
BLUE CROSS BLUE SHIELD

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/31/2016

Provider Address

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