Provider Demographics
NPI:1457789679
Name:HALL, STEPHANIE LEIGH (DVM)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:HALL
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 LEEWARD WALK CIR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-7482
Mailing Address - Country:US
Mailing Address - Phone:470-725-4218
Mailing Address - Fax:
Practice Address - Street 1:741 MONROE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1701
Practice Address - Country:US
Practice Address - Phone:404-817-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5706174M00000X
GA008899174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian