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Omar Dwayne Jack, DO,PA-C
Student in an Organized Health Care Education/Training Program in Buffalo, New York
NPI 1144662909

Omar Dwayne Jack is a Student in an Organized Health Care Education/Training Program based in Buffalo, NY. Omar Dwayne Jack practices in Buffalo, NY and has the professional credentials of DO,PA-C. The NPI Number for Omar Dwayne Jack is 1144662909 and holds a License No. 1109724 (New York).

The current practice location address for Omar Dwayne Jack is 77 Goodell St Ste 550, Buffalo, NY and can be reached out via phone at 716-829-6108.

Location: 77 Goodell St Ste 550, Buffalo, NY, 14203-1258
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144662909
Provider Name
Omar Dwayne Jack
Credential
DO,PA-C
Provider Entity Type
Individual
Gender
Male
Address
77 Goodell St Ste 550, Buffalo, NY, 14203-1258
Phone Number
716-829-6108
Fax Number
Provider Enumeration Date
07/22/2013
Last Update Date
04/13/2024
institution
Provider Business Practice Location Address Details
Address
77 Goodell St Ste 550
City
Buffalo
State
New York
Zip
14203-1258
Phone Number
716-829-6108
Fax Number
person
Provider Business Mailing Address Details
Address
77 Goodell St Ste 550
City
Buffalo
State
New York
Zip
14203-1258
Phone Number
716-829-6108
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
()
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
MA062538 (Pennsylvania)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
1109724 (Georgia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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