Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME43210 | FL |
NPI | 1043202583 |
---|---|
Provider Name | David Earl Hall |
First Address | St Petersburg, FL 33707-1210 |
Second Address | St Petersburg, FL 33707-1210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 23/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0130316 | GHI (01) | FL |
5451200001 | CIGNA GOVERNMENT SERVICES (01) | FL |
62480 | BLUE CROSS/BLUE SHIELD (01) | FL |
D65362 | (02) | FL |
P00240895 | RAILROAD MEDICARE (01) | FL |