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General NPI Number Information
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NPI Number | 1942593603
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Entity Type | Individual
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Provider Name | GEORGE OLIVER HALSTEAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 137 COURT ST SE
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City | ABINGDON
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State | VA
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Zip | 24210-3305
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Country | US
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Telephone | 276-477-1400
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Fax | 276-477-1401
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Provider Business Mailing Address
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Address Line | 2408 SUSANNAH ST STE 1
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City | JOHNSON CITY
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State | TN
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Zip | 37601-1765
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Country | US
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Telephone | 423-434-6677
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Fax | 423-461-0000
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101249165
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License Number State | VA
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