Individual
JASON HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 HARRISON AVE, SUITE 2100, BOSTON, MA 02118
(617) 414-8054
(617) 414-8055
Mailing address
801 ALBANY STREET, FL GROUND, BOSTON, MA 02119
(617) 414-5405
(617) 414-6031
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
211337
MA
208C00000X
Colon & Rectal Surgery Physician
Primary
227619
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110042298A
—
MA
01
—
M20470
MEDICARE - GROUP
—
Enumeration date
01/19/2006
Last updated
08/26/2020
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