Provider Demographics
NPI:1053513135
Name:WEST, JASON ROBBINS (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ROBBINS
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-3536
Mailing Address - Country:US
Mailing Address - Phone:251-675-4733
Mailing Address - Fax:251-619-9874
Practice Address - Street 1:1020 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-3536
Practice Address - Country:US
Practice Address - Phone:251-675-4733
Practice Address - Fax:251-619-9874
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine