Provider Demographics
NPI:1720138118
Name:HALL, LINDA G (DPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:G
Last Name:HALL
Suffix:
Gender:F
Credentials:DPH
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 1085
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38557-1085
Mailing Address - Country:US
Mailing Address - Phone:931-484-9229
Mailing Address - Fax:
Practice Address - Street 1:265 HIGHLAND SQ
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5105
Practice Address - Country:US
Practice Address - Phone:931-456-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist