Provider Demographics
NPI:1134352933
Name:FRIDAY, JASON WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:WILLIAM
Last Name:FRIDAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2730 S VAL VISTA DR
Mailing Address - Street 2:SUITE 137
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1675
Mailing Address - Country:US
Mailing Address - Phone:480-741-8560
Mailing Address - Fax:888-979-8197
Practice Address - Street 1:2730 S VAL VISTA DR
Practice Address - Street 2:SUITE 137
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1675
Practice Address - Country:US
Practice Address - Phone:480-741-8560
Practice Address - Fax:888-979-8197
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ423762084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ614358Medicaid
AZ614358Medicaid