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General NPI Number Information
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NPI Number | 1326514019
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Entity Type | Individual
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Provider Name | DOUGLAS KEITH HALL RN
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Gender | Male
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 765 PIERCE DR
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City | COLUMBUS
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State | OH
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Zip | 43223-2425
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Country | US
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Telephone | 614-223-1650
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Fax |
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Provider Business Mailing Address
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Address Line | 5951 WHITEHAVEN DR
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City | GALLOWAY
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State | OH
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Zip | 43119-8545
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 396098
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License Number State | OH
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