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General NPI Number Information
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NPI Number | 1861745077
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Entity Type | Individual
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Provider Name | JARED ALAN HALL DO
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Gender | Male
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 300 W OTTLEY AVE
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City | FRUITA
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State | CO
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Zip | 81521-2118
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Country | US
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Telephone | 970-858-2186
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Fax | 970-858-2208
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Provider Business Mailing Address
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Address Line | 951 E OTTLEY AVE
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City | FRUITA
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State | CO
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Zip | 81521-2421
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Country | US
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Telephone | 970-402-2230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DR.0071976
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101020492
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | TL3534
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 5101020492
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License Number State | MI
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