Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 2003014735 | MO |
Y | 207T00000X | Neurosurgeon | P0208 | TX |
NPI | 1003015967 |
---|---|
Provider Name | Dr. Jason Andrew Felton |
First Address | Lubbock, TX 79407-3545 |
Second Address | Lubbock, TX 79415-3368 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 18/03/2021 |