Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 1575 | AK |
NPI | 1003803222 |
---|---|
Provider Name | John E Hall |
First Address | Anchorage, AK 99507-1282 |
Second Address | Anchorage, AK 99508-4661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B75121 | (02) | |
MD15751 | (05) | AK |