Provider Demographics
NPI:1023269073
Name:BONSLAVER, JASON S (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:S
Last Name:BONSLAVER
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 1:2350 FREEDOM WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-8200
Mailing Address - Country:US
Mailing Address - Phone:717-741-9536
Mailing Address - Fax:717-741-5509
Practice Address - Street 1:2350 FREEDOM WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8200
Practice Address - Country:US
Practice Address - Phone:717-741-9536
Practice Address - Fax:717-741-5509
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD441958208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program