Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 0000045917 | TN |
N | 207PP0204X | Pediatric Emergency Physician | 0000045917 | TN |
Y | 208000000X | Pediatrician | E-5286 | AR |
NPI | 1760601090 |
---|---|
Provider Name | Michelle B. Hall |
First Address | Knoxville, TN 37919-7411 |
Second Address | Knoxville, TN 37919-7411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 14/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
174234001 | (05) | AR |