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Contact Information

JASON FORT, CST/CSA
2778 E SUPERIOR RD
SAN TAN VALLEY, AZ85143-4573
 Phone: 480-313-9045
 Fax: 480-987-2186
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type
Indicates primary specialty

NPI Profile & details for JASON FORT · (Male)

NPI # 1417228909
Status Active
Credentials CST/CSA
Entity Individual
Enumeration date 01/16/2012
Last updated 08/12/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # L18709787
  • OR License # 454110172
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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