Provider Demographics
NPI:1881792968
Name:JAMES K HALL, JR MD PA
Entity type:Organization
Organization Name:JAMES K HALL, JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:HALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:903-602-6764
Mailing Address - Street 1:400 HOSPITAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2489
Mailing Address - Country:US
Mailing Address - Phone:903-641-4856
Mailing Address - Fax:903-872-5321
Practice Address - Street 1:400 HOSPITAL DR STE 104
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2489
Practice Address - Country:US
Practice Address - Phone:903-874-9106
Practice Address - Fax:833-423-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3816207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X875Medicare UPIN