Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD19686 | TN |
NPI | 1073597423 |
---|---|
Provider Name | William C Hall |
First Address | Knoxville, TN 37923-4563 |
Second Address | Knoxville, TN 37920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 29/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3044444 | (05) | TN |
91928 | BCBS OF TN (01) | TN |
E07087 | (02) | TN |