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General NPI Number Information
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NPI Number | 1104899764
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Entity Type | Individual
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Provider Name | MARK E HALL D.P.M. P.A.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 7556 LAKE WORTH RD SUITE 104
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City | LAKE WORTH
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State | FL
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Zip | 33467-2503
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Country | US
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Telephone | 561-966-5060
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Fax | 561-966-4489
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Provider Business Mailing Address
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Address Line | 7556 LAKE WORTH RD SUITE 104
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City | LAKE WORTH
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State | FL
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Zip | 33467-2503
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Country | US
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Telephone | 561-966-5060
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Fax | 561-966-4489
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P02108
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License Number State | FL
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