MEDICARE: DR. SCOTT ALAN HALL M.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	207Q00000X	Family Medicine Physician	C8260	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	157330000	OTHER	AR	QUALCHOICE

General Provider Information

NPI Number	:	1811963325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALAN HALL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 769
Second Line	:
City	:	HELENA
State	:	AR
Zip	:	72342-0769
Country	:	US
Telephone Number	:	870-338-8312
Fax Number	:	870-338-7702

Provider Business Practice Location Address
First Line	:	812B NEWMAN DR
Second Line	:	SUITE B
City	:	HELENA
State	:	AR
Zip	:	72342-8950
Country	:	US
Telephone Number	:	870-338-8312
Fax Number	:	870-338-7702

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	12/05/2011

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