Provider Demographics
NPI:1861559429
Name:DIOGO, JASON J (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:J
Last Name:DIOGO
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 1:191 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3050
Mailing Address - Country:US
Mailing Address - Phone:508-974-4363
Mailing Address - Fax:
Practice Address - Street 1:191 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3050
Practice Address - Country:US
Practice Address - Phone:508-974-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110079913AMedicaid
MA110079913AMedicaid