Individual
JASON E LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
(210) 567-6418
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
01095802A
IN
2085N0700X
Neuroradiology Physician
R4583
TX
2085R0202X
Diagnostic Radiology Physician
Primary
82198
MN
2085R0202X
Diagnostic Radiology Physician
R4583
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
385426701
—
TX
01
—
385426702
CSHCN
TX
Enumeration date
09/02/2012
Last updated
08/06/2026
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