| Doctor Name: | MR. JASON ANTHONY SKAROSI |
| NPI Number: | 1689833063 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 300 W Hospital Road Eisenhower Army Medical Center Attn Credentials Fort Gordon, GA - 309055650 |
| Business Phone Number: | 7067872720 |
| Business Fax Number: | 7067878176 |
| Mailing Address: | 300 W Hospital Road Eisenhower Army Medical Center, Attn Credentials FORT GORDON |
| State: | GA |
| Postal Code: | 309055650 |
| Phone Number: | 7067872720 |
| Fax Number: | 7067878176 |
| NPI Enumeration Date: | 06/02/2008 |
| NPI Last Update Date: | 06/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |