Healthcare Provider Details

I. General information

NPI: 1598710865
Provider Name (Legal Business Name): JAMES B HALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 GIBSON BLVD SE
ALBUQUERQUE NM
87108-4729
US

IV. Provider business mailing address

PO BOX 676065
DALLAS TX
75267-6065
US

V. Phone/Fax

Practice location:
  • Phone: 904-805-1300
  • Fax: 904-805-1302
Mailing address:
  • Phone: 904-805-1300
  • Fax: 904-805-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number86-243
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: