Individual
MR. EARL MCCAJAH HALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1255 LILA ST, UFJAX - FAMILY MEDICINE AT LEM TURNER, JACKSONVILLE, FL 32208-3550
(904) 244-5700
(904) 244-5791
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1810
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011695800
—
FL
05
—
168512696A
—
GA
01
—
P00054494
RAILROAD
FL
Enumeration date
11/05/2005
Last updated
09/16/2014
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