Healthcare Provider Details

I. General information

NPI: 1497135503
Provider Name (Legal Business Name): JOSHUA ANDREW HALL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 LANGDON ST
SPARTANBURG SC
29302-1614
US

IV. Provider business mailing address

PO BOX 5158
SPARTANBURG SC
29304-5158
US

V. Phone/Fax

Practice location:
  • Phone: 864-582-2411
  • Fax:
Mailing address:
  • Phone: 864-582-2817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number51925
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number2023-01441
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number101052
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number51925
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number6718
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number0102209038
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number05989
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: