Healthcare Provider Details

I. General information

NPI: 1740210962
Provider Name (Legal Business Name): HALLS PHYSICIAN SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 MAYNARDVILLE PIKE HALLS PHYSICIAN SERVICES PLLC
KNOXVILLE TN
37918-5736
US

IV. Provider business mailing address

7000 MAYNARDVILLE PIKE HALLS PHYSICIAN SERVICES PLLC
KNOXVILLE TN
37918-5736
US

V. Phone/Fax

Practice location:
  • Phone: 865-922-1400
  • Fax: 865-922-0928
Mailing address:
  • Phone: 865-922-1400
  • Fax: 865-922-0928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number3795988
License Number StateTN

VIII. Authorized Official

Name: JANET HINKLE
Title or Position: OFFICE MANAGER
Credential:
Phone: 865-922-1400