Healthcare Provider Details

I. General information

NPI: 1275065823
Provider Name (Legal Business Name): GEOFFREY HALL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4709 CREEKSTONE DR STE 100
DURHAM NC
27703-0016
US

IV. Provider business mailing address

616 CANAL ST
DURHAM NC
27701-2504
US

V. Phone/Fax

Practice location:
  • Phone: 919-862-5782
  • Fax:
Mailing address:
  • Phone: 860-307-6192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number2021-00784
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: