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NPI Code Detail

MEDICARE: ERIQ HALL

MEDICARE: ERIQ HALL
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
1152W00000XOptometrist7061OH

General Provider Information

NPI Number : 1790420685
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIQ HALL
Provider Business Mailing Address
First Line : 3293 BLUEMONT PARK
Second Line :
City : HILLIARD
State : OH
Zip : 43026-8752
Country : US
Telephone Number : 440-258-8493
Fax Number :
Provider Business Practice Location Address
First Line : 3959 HOOVER RD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-2839
Country : US
Telephone Number : 614-875-8373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/26/2022

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Directions to “ ERIQ HALL ” Practice Location

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