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General NPI Number Information
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NPI Number | 1417196254
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Entity Type | Individual
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Provider Name | ANDREW BENJAMIN HALL MD
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Gender | Male
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 3250 ZEMKE AVE
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City | TAMPA
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State | FL
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Zip | 33621-5023
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Country | US
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Telephone | 813-529-0361
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Fax |
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Provider Business Mailing Address
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Address Line | 301 FISHER ST
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City | KEESLER AFB
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State | MS
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Zip | 39534-2508
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Country | US
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Telephone | 228-376-3024
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2015025844
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 2015025844
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License Number State | MO
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