Provider Demographics
NPI:1811029325
Name:HALL, JOHN ANDERSON (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDERSON
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 1:184 SPRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:GLENMOORE
Mailing Address - State:PA
Mailing Address - Zip Code:19343-1162
Mailing Address - Country:US
Mailing Address - Phone:610-942-2833
Mailing Address - Fax:
Practice Address - Street 1:184 SPRINGTON RD
Practice Address - Street 2:
Practice Address - City:GLENMOORE
Practice Address - State:PA
Practice Address - Zip Code:19343-1162
Practice Address - Country:US
Practice Address - Phone:610-942-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE006751P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist