Hallock, Jason S.

Hallock, Jason S. is an individual health care provider with primary practice located at 2525 Desales Avenue , Chattanooga TN 37404. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Hallock, Jason S. can be contacted via phone (423) 697-0014.

Contact Information

Primary practice address
2525 Desales Avenue Chattanooga TN 37404
Phone: (423) 697-0014
Fax: (423) 648-6280
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X PA1317 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1317 Tennessee

Profile Details

NPI number 1710922950
LBN Legal business name Hallock, Jason S.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Feb 12th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710922950 NPPES
Georgia MEDICAID 257502672A
Georgia Other 3370172
Georgia Other 3664283
Georgia Other 3726561
Georgia Other 36642831
Georgia Other 4116090

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