Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 21661 | AL |
NPI | 1013917459 |
---|---|
Provider Name | Dr. Charles E Hall JR. |
First Address | Mobile, AL 36608-1162 |
Second Address | Mobile, AL 36608-1162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 18/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G82725 | (02) | AL |