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General NPI Number Information
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NPI Number | 1023110392
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Entity Type | Organization
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Legal Business Name | JOE I HALL MD PC
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 107 J V MANGUBAT DRIVE
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City | WAYNESBORO
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State | TN
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Zip | 38485-2440
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Country | US
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Telephone | 931-722-2800
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Fax | 931-722-9627
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Provider Business Mailing Address
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Address Line | PO BOX 689
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City | WAYNESBORO
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State | TN
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Zip | 38485-0689
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Country | US
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Telephone | 931-722-2800
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Fax | 931-722-9627
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Authorized Official
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Title or Position | CREDENTIALING
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Name | SHERRI L BARBER
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Credential |
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Telephone | 931-722-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25882
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License Number State | TN
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