Provider Demographics
NPI:1114058237
Name:HALL, LES S (RPH)
Entity Type:Individual
Prefix:
First Name:LES
Middle Name:S
Last Name:HALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 KNIGHTSBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6085
Mailing Address - Country:US
Mailing Address - Phone:865-769-9017
Mailing Address - Fax:865-932-1530
Practice Address - Street 1:7510 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-3811
Practice Address - Country:US
Practice Address - Phone:865-933-4635
Practice Address - Fax:865-932-1530
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist