Individual
DR. HEATHER HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
35 HOSPITAL WAY, BLAIRSVILLE, GA 30512
(912) 257-5719
Mailing address
3255 BROWNLEE LN SW, LILBURN, GA 30047-1907
(912) 257-5719
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
055522
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055522
LICENSE
GA
05
—
512696750C
—
GA
01
—
P00336816
RAILROAD MEDICARE
GA
Enumeration date
04/25/2006
Last updated
11/28/2016
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