Individual
BRANDON HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3200 N ASHLEY ST STE C, VALDOSTA, GA 31602-5911
(229) 671-9100
(229) 671-9101
Mailing address
903 WARD ST W STE A, DOUGLAS, GA 31533-3536
(912) 260-1191
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
227503
GA
Other
Enumeration date
05/16/2018
Last updated
06/16/2021
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