Provider Demographics
NPI:1245392273
Name:HALL, GAIRY F (MD)
Entity Type:Individual
Prefix:
First Name:GAIRY
Middle Name:F
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CHEROKEE ROSE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-3459
Mailing Address - Country:US
Mailing Address - Phone:617-373-5190
Mailing Address - Fax:
Practice Address - Street 1:NORTHEASTERN UNIVERSITY
Practice Address - Street 2:135 FORSYTH BUILDING
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-373-5190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227053207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine