Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 07000762A | IN |
NPI | 1053393355 |
---|---|
Provider Name | Dr. Gerry L Hash |
First Address | Bloomington, IN 47401-5515 |
Second Address | Bloomington, IN 47401-5515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 15/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100184980 | (05) | IN |
U19504 | (02) | IN |