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General NPI Number Information
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NPI Number | 1962669572
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Entity Type | Organization
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Legal Business Name | ERIC L. HALL, MD; PC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 512 S MAIN ST SUITE B
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City | HINESVILLE
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State | GA
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Zip | 31313-4325
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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 SUITE B
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City | HINESVILLE
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State | GA
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Zip | 31313-4325
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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 | PRESIDENT
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Name | ERIC LEE HALL
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Credential | M.D.
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Telephone | 912-369-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 045814
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License Number State | GA
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