Healthcare Provider Details

I. General information

NPI: 1073476412
Provider Name (Legal Business Name): MARGO HALL CFM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6544 E TANQUE VERDE RD STE 130
TUCSON AZ
85715-3843
US

IV. Provider business mailing address

6544 E TANQUE VERDE RD STE 130
TUCSON AZ
85715-3843
US

V. Phone/Fax

Practice location:
  • Phone: 520-770-7870
  • Fax:
Mailing address:
  • Phone: 520-770-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License NumberC73954
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: