Provider Demographics
NPI:1881822120
Name:HALL, JAMES MELVEN (MHPP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MELVEN
Last Name:HALL
Suffix:
Gender:M
Credentials:MHPP
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 1589
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-1589
Mailing Address - Country:US
Mailing Address - Phone:501-315-3344
Mailing Address - Fax:501-315-1388
Practice Address - Street 1:1708 E PAGE AVE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-4540
Practice Address - Country:US
Practice Address - Phone:501-332-4437
Practice Address - Fax:501-303-3187
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator