Individual
DR. MARK E HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M. P.A.
Contact information
Practice address
7556 LAKE WORTH RD, SUITE 104, LAKE WORTH, FL 33467-2503
(561) 966-5060
(561) 966-4489
Mailing address
7556 LAKE WORTH RD, SUITE 104, LAKE WORTH, FL 33467-2503
(561) 966-5060
(561) 966-4489
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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