Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 390200000X | MO |
Y | 207QS0010X | Family Doctor - Sports Medicine | 05-34983 | KS |
N | 207QS0010X | Family Doctor - Sports Medicine | 0534983 | KS |
N | 207QS0010X | Family Doctor - Sports Medicine | DR.0050921 | CO |
NPI | 1285700088 |
---|---|
Provider Name | Dr. Jarrod Michael Harrall |
First Address | Lawrence, KS 66045-4069 |
Second Address | Colorado Springs, CO 80920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 16/12/2021 |