Healthcare Provider Details

I. General information

NPI: 1265614432
Provider Name (Legal Business Name): RANDALL L. HALL, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N SECTION ST
FAIRHOPE AL
36532-2613
US

IV. Provider business mailing address

405 N SECTION ST
FAIRHOPE AL
36532-2613
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-8860
  • Fax: 251-990-3401
Mailing address:
  • Phone: 251-990-8860
  • Fax: 251-990-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LYNN E. YONGE
Title or Position: OWNER
Credential: MD
Phone: 251-990-8860