Healthcare Provider Details

I. General information

NPI: 1457789679
Provider Name (Legal Business Name): STEPHANIE LEIGH HALL DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 STATE BRIDGE RD STE 120
JOHNS CREEK GA
30022-4301
US

IV. Provider business mailing address

11720 LEEWARD WALK CIR
ALPHARETTA GA
30005-7482
US

V. Phone/Fax

Practice location:
  • Phone: 470-742-4620
  • Fax:
Mailing address:
  • Phone: 470-725-4218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number5706
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number008899
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT011838
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: