Individual
DR. JASON B HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 744-4757
(252) 744-5014
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9900860
NC
207P00000X
Emergency Medicine Physician
MD12717
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007060416
RI MEDICARE
RI
01
—
01/27/2009
TUFTS HEALTH PLAN
MA
01
—
08/26/2008
BCBSRI
RI
01
—
09/11/2008
NHPRI
RI
01
—
1053303768
NPI
RI
01
—
1210A
BCBS NC
NC
05
—
2157683
—
MA
05
—
891210A
—
NC
01
—
930080949
RAILROAD MEDICARE
NC
05
—
JH72236
—
RI
Enumeration date
08/18/2005
Last updated
02/13/2024
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