Jack E Hall, PA is a
Physician Assistant - Medical based in Pueblo West, Colorado. Jack E Hall is licensed to practice in Colorado (license number 535) and his current practice location is
121 S Crescent Dr, Pueblo West, Colorado. He can be reached at his office (for appointments etc.) via phone at
(719) 595-7575.
NPI number for Jack E Hall is 1619284239 and his current mailing address is Po Box 560825, Denver, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619284239.
Provider's Profile
| Full Name | Jack E Hall |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant - Medical |
|---|
| Location | 121 S Crescent Dr, Pueblo West, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1619284239
- Provider Enumeration Date: 09/02/2010
- Last Update Date: 02/18/2016
Medical Identifiers
Medical identifiers for Jack E Hall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619284239 | NPI | - | NPPES |
| 63254808 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | 535 (Colorado) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack E Hall is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack E Hall, PA
Po Box 560825,
Denver, CO 80256-0825
Ph: (719) 595-7580 | Jack E Hall, PA
121 S Crescent Dr,
Pueblo West, CO 81007-5434
Ph: (719) 595-7575 |
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