Provider Demographics
NPI:1811924418
Name:HALL, JOHN A (PA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:HALL
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1670 CLAIRMONT RD
Mailing Address - Street 2:SURGICAL SERVICE-UROLOGY SECTION
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4004
Mailing Address - Country:US
Mailing Address - Phone:404-728-4122
Mailing Address - Fax:404-329-2201
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:SURGICAL SERVICE-UROLOGY SECTION
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-728-4122
Practice Address - Fax:404-329-2201
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-06-18
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Provider Licenses
StateLicense IDTaxonomies
GA003066363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical