Healthcare Provider Details

I. General information

NPI: 1306762406
Provider Name (Legal Business Name): DR. JANICE L HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 N BROOKS ST
PONTOTOC MS
38863-1601
US

IV. Provider business mailing address

235 N BROOKS ST
PONTOTOC MS
38863-1601
US

V. Phone/Fax

Practice location:
  • Phone: 662-341-5780
  • Fax:
Mailing address:
  • Phone: 662-341-5780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: