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Individual
DR. MARK E HALL
Active
Individual
DR. MARK E HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M. P.A.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P02108
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057613100
—
FL
01
—
65-0960025
TAX ID #
FL
01
—
65220
BC/BS OF FL
FL
01
—
P02108
FLORIDA LICENSE #
FL
Enumeration date
02/13/2006
Last updated
01/14/2011
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