Provider Demographics
NPI:1962486381
Name:HALL, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 OLD MILTON PKWY STE C270
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4414
Mailing Address - Country:US
Mailing Address - Phone:770-442-1911
Mailing Address - Fax:770-663-8905
Practice Address - Street 1:3400 OLD MILTON PKWY
Practice Address - Street 2:SUITE 270
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3707
Practice Address - Country:US
Practice Address - Phone:770-442-1911
Practice Address - Fax:770-663-8905
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA038791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA08BDLTHMedicare UPIN
GAC72309Medicare UPIN
GAGRP264Medicare PIN