# DR. JASON RYAN GREENHALGH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1952478703
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | M-11276 | ID | Yes |
| 208800000X | Urology Physician | R-7693 | IA | — |

## Other

- **Enumeration date:** 11/29/2006
- **Last updated:** 12/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1952478703 | — | ID |
| 01 | — | P00983738 | MCRR | ID |