Jared Eugene Hall, ATC

Individual provider Active NPI Athletic Trainer · Rensselaer, IN

NPI 1346277134 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346277134
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
36000390A (IN)
Practice address
1104 East Grace Street
Jasper County Hospital
Rensselaer, IN 47978-3211
Phone
(219) 866-5141
Fax
(219) 866-3234
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
36000390AINMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36000390A IN Yes

Addresses

Primary practice location

1104 East Grace Street
Jasper County Hospital
Rensselaer, IN 47978-3211

Mailing address

1104 East Grace Street
Rensselaer, IN 47978-3211
Phone (219) 866-5141

Other providers in Rensselaer, IN

All providers in Rensselaer, IN · Athletic Trainer in Indiana

Sources for this page

Verify at the official NPI Registry.