Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036069953 | IL |
N | 208600000X | Surgeon | 036069953 | IL |
Y | 208200000X | Surgeon | MD175340 | OR |
Y | 208600000X | Surgeon | MD175340 | OR |
N | 2086X0206X | Surgical Oncologist | 036-069953 | IL |
NPI | 1003993064 |
---|---|
Provider Name | Dr. Terrence J Hall |
First Address | Coquille, OR 97423-1666 |
Second Address | Coquille, OR 97423-1666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 25/02/2016 |