Healthcare Provider Details

I. General information

NPI: 1295732014
Provider Name (Legal Business Name): MARY JO HALL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY JO FOREMAN M.D.

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 5TH AVE STE 103
CHAMBERSBURG PA
17201-4224
US

IV. Provider business mailing address

111 CHAMBERS HILL DR STE 200
CHAMBERSBURG PA
17201-7304
US

V. Phone/Fax

Practice location:
  • Phone: 717-709-7950
  • Fax: 717-263-8898
Mailing address:
  • Phone: 717-709-7922
  • Fax: 717-263-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD419110
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: