Provider Demographics
NPI:1164818720
Name:HALL, CALTON JR (PA-C ATC)
Entity Type:Individual
Prefix:
First Name:CALTON
Middle Name:
Last Name:HALL
Suffix:JR
Gender:M
Credentials:PA-C ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JAMES MADISON UNIVERSITY
Mailing Address - Street 2:MSC 2301
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22807-0001
Mailing Address - Country:US
Mailing Address - Phone:540-578-0749
Mailing Address - Fax:
Practice Address - Street 1:3475 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-0005
Practice Address - Country:US
Practice Address - Phone:919-668-5416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260020702255A2300X
NC0010-12695363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer