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Contact Information

JASON M MACCANNON, ATC, LAT
COLLEGE BACKBONE RD
PRINCESS ANNE, MD21853
 Phone: 410-651-6510
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for JASON M MACCANNON · (Male)

NPI Number 1548863186
Status Active
Credentials ATC, LAT
Entity Individual
Enumeration date 11/17/2020
Last updated 11/17/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • MD License # A0001341
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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