Healthcare Provider Details

I. General information

NPI: 1841389475
Provider Name (Legal Business Name): MELVIN CHARLES HALE CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 HIGHWAY 34 E SUITE 15
NEWNAN GA
30265-2126
US

IV. Provider business mailing address

115 BEECHVALLEY DR
SHARPSBURG GA
30277-1936
US

V. Phone/Fax

Practice location:
  • Phone: 770-683-4870
  • Fax: 770-683-4872
Mailing address:
  • Phone: 770-251-8595
  • Fax: 770-683-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: