Provider Demographics
NPI:1942739453
Name:HALE, MEREDITH ANN (DO)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANN
Last Name:HALE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ANN
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1033 ASHLAND RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2156
Mailing Address - Country:US
Mailing Address - Phone:567-345-3030
Mailing Address - Fax:567-345-3031
Practice Address - Street 1:1033 ASHLAND RD STE 205
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-2156
Practice Address - Country:US
Practice Address - Phone:567-345-3030
Practice Address - Fax:567-345-3031
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.014256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program