JACK E HALL PA NPI 1619284239

NPI Information

  • NPI: 1619284239
  • Provider Name: JACK E HALL, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 121 S CRESCENT DR
    PUEBLO WEST, CO
    ZIP 81007
  • Phone: (719) 595-7575

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NPI Details

Jack E Hall, PA is a medical physician assistant in Pueblo West, CO. Jack E Hall, PA NPI is 1619284239. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

121 S CRESCENT DR
PUEBLO WEST, CO
ZIP 81007-434
Phone: (719) 595-7575
Fax: (719) 547-8368

The enumeration date for this NPI number is 9/2/2010 and was last updated on 2/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical535COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
163254808MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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