Provider Demographics
NPI:1801110010
Name:BONEY, JASON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:BONEY
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 1:530 NANTASKET AVE
Mailing Address - Street 2:APT 306
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-2557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 KIMBALL BEACH RD
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1146
Practice Address - Country:US
Practice Address - Phone:617-500-4097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA01130415207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine