Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | ME99654 | FL |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME99654 | FL |
NPI | 1891714572 |
---|---|
Provider Name | Dr. Daniel Jackson Hall |
First Address | Gainesville, FL 32607-2557 |
Second Address | Gainesville, FL 32607-2557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 16/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001557100 | (05) | FL |
312072 | AVMED (01) | FL |
H53811 | (02) | FL |