Individual
JERRELL INGALLS
Active
Individual
JERRELL INGALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13857
NV
2085R0202X
Diagnostic Radiology Physician
35.093043
OH
2085R0202X
Diagnostic Radiology Physician
4301083659
MI
2085R0202X
Diagnostic Radiology Physician
43663
KY
2085R0202X
Diagnostic Radiology Physician
MD60547691
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851517999
—
CA
05
—
1851517999
—
NV
05
—
200469660A
—
OK
05
—
624266
—
AZ
01
—
P01168760
RR MEDICARE
NV
Enumeration date
04/17/2007
Last updated
07/05/2024
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