Healthcare Provider Details

I. General information

NPI: 1073597423
Provider Name (Legal Business Name): WILLIAM C HALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BLOUNT AVE SUITE 800
KNOXVILLE TN
37920
US

IV. Provider business mailing address

9125 CROSS PARK DR STE 200
KNOXVILLE TN
37923-4563
US

V. Phone/Fax

Practice location:
  • Phone: 865-632-5900
  • Fax:
Mailing address:
  • Phone: 865-632-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD19686
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: