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General NPI Number Information
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NPI Number | 1265566145
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Entity Type | Individual
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Provider Name | ROGER CHARLES HALL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 89 HOSPITAL ST SUITE 1
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City | AUGUSTA
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State | ME
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Zip | 04330-6651
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Country | US
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Telephone | 207-622-6193
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Fax | 207-621-0602
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Provider Business Mailing Address
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Address Line | 203 HANNAFORD HILL RD
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City | VASSALBORO
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State | ME
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Zip | 04989-4217
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Country | US
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Telephone | 207-622-6193
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Fax | 207-621-0602
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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 | 009795
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License Number State | ME
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