Provider Demographics
NPI:1205923042
Name:HALL, RUSSELL PRITCHETT III (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:PRITCHETT
Last Name:HALL
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 3135
Mailing Address - Street 2:DUKE UNIVERSITY MEDICAL CENTER
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-3135
Mailing Address - Country:US
Mailing Address - Phone:919-684-3110
Mailing Address - Fax:919-684-3002
Practice Address - Street 1:200 TRENT DRIVE
Practice Address - Street 2:DUKE UNIVERSITY MEDICAL CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27715-3135
Practice Address - Country:US
Practice Address - Phone:919-684-3110
Practice Address - Fax:919-684-3002
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-10-11
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Provider Licenses
StateLicense IDTaxonomies
NC27920207N00000X, 207NI0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2069477Medicare PIN
NCC84283Medicare UPIN