Provider Demographics
NPI:1710378401
Name:JASON J. HALL, MD, PLLC
Entity Type:Organization
Organization Name:JASON J. HALL, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-973-9500
Mailing Address - Street 1:9239 PARKWEST BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923
Mailing Address - Country:US
Mailing Address - Phone:865-973-9500
Mailing Address - Fax:865-973-9575
Practice Address - Street 1:9239 PARK WEST BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4403
Practice Address - Country:US
Practice Address - Phone:865-973-9500
Practice Address - Fax:865-973-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52085208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty