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Individual

MS. MARY ALICE HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9788 KY RT 122, STE 2, MC DOWELL, KY 41647-6042
(606) 377-2492
(606) 377-1018
Mailing address
PO BOX 277, MC DOWELL, KY 41647-0277
(606) 377-2492
(606) 377-1018

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13655
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000048789
ANTHEM BLUE CROSS/SHIELD
01
011769726
PALMETTO RAILROAD MEDICAR
01
020364400
FEDERAL BLACK LUNG/DOL
01
0303224
UMWA
01
230264400
DEPT OF LABOR/ACS UNIT/WO
05
64136559
KY
Enumeration date
08/31/2006
Last updated
10/27/2011
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