Individual
TAD ALAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 WANDA ST, MARIETTA, OK 73448-1200
(580) 276-3347
(580) 276-2182
Mailing address
300 WANDA ST, MARIETTA, OK 73448-1200
(580) 276-3347
(580) 276-2182
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
377
OK
Other
Enumeration date
05/12/2006
Last updated
11/21/2007
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