# JARED A HALL DPM PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699904458
- **Authorized official:** JARED A HALL DPM (PRESIDENT)
- **Authorized official phone:** (928) 537-4111

## Contact information

- **Practice address:** 5171 S CUB LAKE RD STE B230, SHOW LOW, AZ 85901-7882
- **Practice address phone:** (928) 537-4111
- **Practice address fax:** (928) 537-4111
- **Mailing address:** 5171 S CUB LAKE RD STE B230, SHOW LOW, AZ 85901-7882
- **Mailing address phone:** (928) 537-4111
- **Mailing address fax:** (928) 532-1123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 0667 | AZ | Yes |

## Other

- **Enumeration date:** 07/14/2009
- **Last updated:** 08/26/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 271532 | AHCCCS | AZ |