Jerry Hall, P.A.-C

Individual provider Active NPI Physician Assistant · Pigeon, MI

NPI 1295761369 · NPPES record last updated Nov 11, 2009

Key facts

NPI
1295761369
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
5601001060 (MI)
Practice address
168 N Caseville Rd
Pigeon, MI 48755-9704
Phone
(989) 453-2141
Fax
(989) 453-4550
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601001060MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scheurer Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601001060 MI Yes

Addresses

Primary practice location

168 N Caseville Rd
Pigeon, MI 48755-9704

Mailing address

168 N Caseville Rd
Pigeon, MI 48755-9704
Phone (989) 453-5210

Other providers in Pigeon, MI

All providers in Pigeon, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.