Provider Demographics
NPI:1780146704
Name:HALL, CHRISTINA Y (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:Y
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 3RD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1900
Mailing Address - Country:US
Mailing Address - Phone:229-312-5839
Mailing Address - Fax:229-312-5815
Practice Address - Street 1:2336 DAWSON RD STE 1500
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2802
Practice Address - Country:US
Practice Address - Phone:229-312-8800
Practice Address - Fax:229-312-8895
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X
GA90811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program