Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 35.081413 | OH |
Y | 2080P0203X | Pediatric Critical Care Doctor | 35081413 | OH |
NPI | 1215929641 |
---|---|
Provider Name | Mark William Hall |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 04/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2001494000 | (05) | WV |
2291685 | (05) | OH |
64055312 | (05) | KY |