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NPI 1568438521

NPI 1568438521 : ERIC LEE HALL M.D. : HINESVILLE, GA

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General NPI Number Information
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    NPI Number           |    1568438521
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC LEE HALL M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/28/2006
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    Last Update Date     |    08/09/2021
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Provider Practice Location Address
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    Address Line         |    512 S MAIN ST STE A 
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    City                 |    HINESVILLE
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    State                |    GA
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    Zip                  |    31313-4344
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    Country              |    US
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    Telephone            |    912-369-5437
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    Fax                  |    912-369-5740
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Provider Business Mailing Address
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    Address Line         |    512 S MAIN ST STE A 
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    City                 |    HINESVILLE
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    State                |    GA
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    Zip                  |    31313-4344
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    Country              |    US
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    Telephone            |    912-369-5437
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    Fax                  |    912-369-5740
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    045814
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    License Number State |    GA
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