MEDICARE: DR. ALLISON NICOLE HALL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2537	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629061502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON NICOLE HALL O.D.

Provider Business Mailing Address
First Line	:	1 COLONIAL SQ
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-3633
Country	:	US
Telephone Number	:	479-702-2022
Fax Number	:	479-705-2023

Provider Business Practice Location Address
First Line	:	1 COLONIAL SQ
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-3633
Country	:	US
Telephone Number	:	479-702-2022
Fax Number	:	479-705-2023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	11/14/2025

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