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General NPI Number Information
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NPI Number | 1629072319
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Entity Type | Individual
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Provider Name | CLAYTON S HALL DO
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | TRM PLAZA, HWY 644 SUITE 3
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City | LOUISA
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State | KY
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Zip | 41230
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Country | US
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Telephone | 606-638-3813
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Fax | 606-638-3867
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Provider Business Mailing Address
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Address Line | PO BOX 30
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City | LOUISA
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State | KY
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Zip | 41230-0030
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Country | US
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Telephone | 606-638-3813
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Fax | 606-638-3867
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 02877
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License Number State | KY
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