IndividualActive
Jason Fort, CST/CSA
NPI 1417228909 · Surgical Technologist · San Tan Valley, AZ
Provider details
- NPI number
- 1417228909
- Entity type
- Individual
- Primary specialty
- Surgical TechnologistTechnologists, Technicians & Other Technical Service Providers
- Credential
- CST/CSA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 454110172 (OR)
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Technologists, Technicians & Other Technical Service Providers
Practice location
2778 E Superior Rd
San Tan Valley, AZ 85143-4573
Phone: (480) 313-9045
Fax: (480) 987-2186
Approximate (ZIP-level) locationGet directions
Mailing address
2778 E Superior Rd
San Tan Valley, AZ 85143-4573
Registry dates
- Enumerated
- 2012-01-16
- Last updated
- 2014-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.