Provider Demographics
NPI:1790768513
Name:HALL, WILLIAM H III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:HALL
Suffix:III
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 1:381 W HORTON RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7740
Mailing Address - Country:US
Mailing Address - Phone:360-370-2873
Mailing Address - Fax:360-818-2873
Practice Address - Street 1:381 W HORTON RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7740
Practice Address - Country:US
Practice Address - Phone:360-370-2873
Practice Address - Fax:360-818-2873
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD600011262085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8509432Medicaid