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Individual

DR. JASON ANDREW HALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0006
(785) 239-7151
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0006

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021028956
MO
208D00000X
General Practice Physician
2021028956
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/17/2020
Last updated
04/30/2024
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