Healthcare Provider Details

I. General information

NPI: 1811963325
Provider Name (Legal Business Name): SCOTT ALAN HALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812B NEWMAN DR SUITE B
HELENA AR
72342-8950
US

IV. Provider business mailing address

PO BOX 769
HELENA AR
72342-0769
US

V. Phone/Fax

Practice location:
  • Phone: 870-338-8312
  • Fax: 870-338-7702
Mailing address:
  • Phone: 870-338-8312
  • Fax: 870-338-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC8260
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: