Individual
DR. EDWARD JASON HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1014 E WASHINGTON, GREENVILLE, MI 48838
(616) 754-7145
(616) 754-7110
Mailing address
PO BOX 730, 406 E ELM ST, CARSON CITY, MI 48811
(989) 584-3131
(989) 584-6734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101014725
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080195443
RAILROAD MEDICARE PTAN
MI
05
—
4592581
—
MI
Enumeration date
02/13/2006
Last updated
12/03/2009
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