Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 15188 | NH |
NPI | 1033378831 |
---|---|
Provider Name | Dr. Jason Alan Hall |
First Address | Manchester, NH 03104-2420 |
Second Address | Manchester, NH 03104-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 11/07/2012 |