Individual
JON M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4015 GATEWAY BLVD, NEWBURGH, IN 47630-8925
(812) 858-9400
(812) 858-9571
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 858-9400
(812) 858-9571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000521187
BCBS PIN
IN
05
—
200263090
—
IN
Enumeration date
09/21/2006
Last updated
03/12/2013
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