Healthcare Provider Details

I. General information

NPI: 1801424502
Provider Name (Legal Business Name): WILLIAM L HALL III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2020
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 40TH ST
BAKERSFIELD CA
93301-1224
US

IV. Provider business mailing address

500 40TH ST
BAKERSFIELD CA
93301-1224
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-3784
  • Fax: 661-327-0164
Mailing address:
  • Phone: 661-327-3784
  • Fax: 661-327-0164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA185643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: