MEDICARE: KENT N 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
1	207P00000X	Emergency Medicine Physician	262733	NY

General Provider Information

NPI Number	:	1851395354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENT N HALL MD

Provider Business Mailing Address
First Line	:	PO BOX 2868
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-0259
Country	:	US
Telephone Number	:	518-562-7371
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 BEEKMAN STREET
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-0259
Country	:	US
Telephone Number	:	518-562-7371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	12/01/2011

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