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Jason Alan Tiede, PA
Medical Physician Assistant in Joplin, Missouri
NPI 1629084900

Jason Alan Tiede is a Medical Physician Assistant based in Joplin, MO and is specialized in Medical. Jason Alan Tiede practices in Joplin, MO and has the professional credentials of PA. The NPI Number for Jason Alan Tiede is 1629084900 and holds a License No. 117822 (Missouri).

The current practice location address for Jason Alan Tiede is 1800 W 30Th St, Joplin, MO and can be reached out via phone at 417-782-5000 and via fax at 417-782-2945.

Location: 1800 W 30Th St, Joplin, MO, 64804-1520
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629084900
Provider Name
Jason Alan Tiede
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1800 W 30Th St, Joplin, MO, 64804-1520
Phone Number
417-782-5000
Fax Number
417-782-2945
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0000426956 01 KS BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1800 W 30Th St
City
Joplin
State
Missouri
Zip
64804-1520
Phone Number
417-782-5000
Fax Number
417-782-2945
person
Provider Business Mailing Address Details
Address
1800 W 30Th St
City
Joplin
State
Missouri
Zip
64804-1520
Phone Number
417-782-5000
Fax Number
417-782-2945
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
117822 (Missouri)
Definition
Definition to come...
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