Individual
DR. JASON WAYNE HULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 MILLCREEK PLZ, ERIE, PA 16565-1102
(814) 864-4858
(814) 864-0398
Mailing address
1471 HENDERSONVILLE RD, SANDY LAKE, PA 16145-3419
(724) 376-3785
(814) 864-0398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PA OEG000291
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376280
BLUE CROSS BLUE SHIELD
PA
01
—
397164
NAT'L VISION ADMIN (NVA)
PA
Enumeration date
10/16/2006
Last updated
06/25/2012
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