Jack E Hall, PA | |
121 S Crescent Dr, Pueblo West, CO 81007-5434 | |
(719) 595-7575 | |
(719) 547-8368 |
Full Name | Jack E Hall |
---|---|
Gender | Male |
Speciality | Physician Assistant - Medical |
Location | 121 S Crescent Dr, Pueblo West, Colorado |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619284239 | NPI | - | NPPES |
63254808 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363AM0700X | Physician Assistant - Medical | 535 (Colorado) | Primary |
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 |
Brooke Nicole Deweese, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 121 S. Crescent Drive, Pueblo West, CO 81007 Phone: 719-595-7575 Fax: 719-288-2799 | |
Kelsey E Barton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 121 S Crescent Dr Ste B, Pueblo West, CO 81007 Phone: 719-547-3924 |