Individual
DR. EDMOND HARTLEY THALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
223 GRAPPA FARMS DR, HIGHLAND HEIGHTS, OH 44143-3720
(231) 220-5369
Mailing address
223 GRAPPA FARMS DR, HIGHLAND HEIGHTS, OH 44143-3720
(231) 220-5369
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
42566
CO
207W00000X
Ophthalmology Physician
Primary
LT23941
ND
207W00000X
Ophthalmology Physician
Primary
MD033759E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127627104
—
TX
05
—
64432017
—
CO
Enumeration date
04/09/2006
Last updated
03/04/2026
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