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General NPI Number Information
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NPI Number | 1295895423
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Entity Type | Individual
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Provider Name | LASHLEY TODD HALL PA
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/15/2009
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Provider Practice Location Address
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Address Line | 801 W GORDON ST
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City | THOMASTON
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State | GA
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Zip | 30286-3426
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Country | US
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Telephone | 706-647-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 861 SW 78TH AVE SUITE # 100-B
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City | PLANTATION
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State | FL
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Zip | 33324-3273
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3757
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License Number State | GA
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