Provider Demographics
NPI:1619177805
Name:HALL, WESLEY ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:ALAN
Last Name:HALL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6518
Mailing Address - Country:US
Mailing Address - Phone:405-329-8800
Mailing Address - Fax:405-329-8800
Practice Address - Street 1:2109 IOWA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6518
Practice Address - Country:US
Practice Address - Phone:405-329-8800
Practice Address - Fax:405-329-8800
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist