Provider Demographics
NPI:1871589374
Name:CHO, JASON J (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:J
Last Name:CHO
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 1:655 SOUTH 7TH STREET BLDG 700/700-A
Mailing Address - Street 2:78 MDG
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 SOUTH 7TH STREET BLDG 700/700-A
Practice Address - Street 2:78 MDG
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098
Practice Address - Country:US
Practice Address - Phone:478-327-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068203L2083A0100X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD-000Medicare UPIN