Provider Demographics
NPI:1164767281
Name:HALL, JAMILA
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 MARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2409
Mailing Address - Country:US
Mailing Address - Phone:501-850-8788
Mailing Address - Fax:501-850-8791
Practice Address - Street 1:231 MARKWOOD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2409
Practice Address - Country:US
Practice Address - Phone:501-850-8788
Practice Address - Fax:501-850-8791
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist