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General NPI Number Information
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NPI Number | 1083725204
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Entity Type | Individual
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Provider Name | MARY ALICE HALL MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 9788 KY RT 122 STE 2
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City | MC DOWELL
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State | KY
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Zip | 41647-6042
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Country | US
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Telephone | 606-377-2492
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Fax | 606-377-1018
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Provider Business Mailing Address
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Address Line | PO BOX 277
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City | MC DOWELL
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State | KY
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Zip | 41647-0277
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Country | US
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Telephone | 606-377-2492
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Fax | 606-377-1018
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 13655
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License Number State | KY
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