Provider Demographics
NPI:1801011887
Name:HALL, WILLIAM BRUCE (INDEPEND CARE GIVER)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRUCE
Last Name:HALL
Suffix:
Gender:M
Credentials:INDEPEND CARE GIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1431
Mailing Address - Street 2:46115 US HWY 36 LOT 45
Mailing Address - City:COSHORTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46115 US HWY 36 LOT 45
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1431
Practice Address - Country:US
Practice Address - Phone:740-622-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
2444706Medicare UPIN