Individual
DR. FREDERICK JACQUES HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(678) 640-5685
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(678) 640-5685
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
POD000612
GA
213ES0131X
Foot Surgery Podiatrist
Primary
POD000612
GA
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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