Healthcare Provider Details

I. General information

NPI: 1699156364
Provider Name (Legal Business Name): MEGAN THOMPSON HALL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N 1ST ST STE 120
FRESNO CA
93726-6818
US

IV. Provider business mailing address

3636 N 1ST ST STE 120
FRESNO CA
93726-6818
US

V. Phone/Fax

Practice location:
  • Phone: 595-224-4365
  • Fax: 559-224-4354
Mailing address:
  • Phone: 595-224-4365
  • Fax: 559-224-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR3877
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number51932
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4593
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A23864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: