Provider Demographics
NPI:1578833026
Name:HALL, MARK DONALD (PA-C)
Entity Type:Individual
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First Name:MARK
Middle Name:DONALD
Last Name:HALL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9320 S MINGO RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5710
Mailing Address - Country:US
Mailing Address - Phone:918-879-1700
Mailing Address - Fax:918-879-1701
Practice Address - Street 1:9320 S MINGO RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5710
Practice Address - Country:US
Practice Address - Phone:918-901-9701
Practice Address - Fax:918-901-9702
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2019-04-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant