Provider Demographics
NPI:1285700088
Name:HARRALL, JARROD MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:JARROD
Middle Name:MICHAEL
Last Name:HARRALL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1651 NAISMITH DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66045-4069
Mailing Address - Country:US
Mailing Address - Phone:785-864-2306
Mailing Address - Fax:
Practice Address - Street 1:2446 RESEARCH PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-623-1050
Practice Address - Fax:719-623-1051
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO390200000X207Q00000X
CODR.0050921207QS0010X
KS0534983207QS0010X
KS05-34983207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine