Provider Demographics
NPI:1619098936
Name:HALL, SUSAN J (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:HALL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:POST OFFICE BOX 2859
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-2859
Mailing Address - Country:US
Mailing Address - Phone:941-364-9437
Mailing Address - Fax:941-364-9527
Practice Address - Street 1:3530 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-9026
Practice Address - Country:US
Practice Address - Phone:941-552-8808
Practice Address - Fax:941-552-8805
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2010-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL47382083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine