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General NPI Number Information
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NPI Number | 1699679787
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Entity Type | Organization
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Legal Business Name | LATRISHAHALLDO, PLLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 1201 OAK ST
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City | CONWAY
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State | AR
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Zip | 72032-5316
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Country | US
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Telephone | 501-764-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 701 SOUTH ST STE 100
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4452
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Country | US
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Telephone | 501-764-4800
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/ OWNER
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Name | LATRISHA HALL
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Credential | DO
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Telephone | 501-764-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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