Provider Demographics
NPI:1730298340
Name:DAVID D HALL DO PC
Entity Type:Organization
Organization Name:DAVID D HALL DO PC
Other - Org Name:BEHAVIORAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN PSYCHIATRIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-272-3889
Mailing Address - Street 1:PO BOX 230310
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123-0310
Mailing Address - Country:US
Mailing Address - Phone:334-272-3889
Mailing Address - Fax:334-272-4089
Practice Address - Street 1:6324 WOODMERE BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-272-3889
Practice Address - Fax:334-272-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL283101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529913900Medicaid
AL51512608Medicare ID - Type Unspecified
B84904Medicare UPIN