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NPI Code Detail

MEDICARE: LESLIE W HALL MD

MEDICARE: LESLIE W HALL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianR2J99MO
2207R00000XInternal Medicine Physician37695SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1394166OTHERMOHEALTHLINK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3128011OTHERMOBLUE SHIELD/BLUE CHOICE
4400639OTHERMOUNITED HEALTHCARE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306883970
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE W HALL MD
Provider Business Mailing Address
First Line : PO BOX 743904
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3904
Country : US
Telephone Number : 803-296-7320
Fax Number : 803-296-7330
Provider Business Practice Location Address
First Line : 1801 SUNSET DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-6803
Country : US
Telephone Number : 803-434-4100
Fax Number : 803-434-4155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 04/23/2021

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Directions to “ LESLIE W HALL MD” Practice Location

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