Healthcare Provider Details

I. General information

NPI: 1467530717
Provider Name (Legal Business Name): JAMES HALL PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E HARTFORD AVE STE A
PONCA CITY OK
74601-2011
US

IV. Provider business mailing address

900 E HARTFORD AVE STE A
PONCA CITY OK
74601-2011
US

V. Phone/Fax

Practice location:
  • Phone: 580-762-4103
  • Fax:
Mailing address:
  • Phone: 580-762-4103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number200438
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number2141
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: