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Individual

DR. LARRY JENE HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2010 OPPORTUNITY LANE, GLIDE, OR 97443-9779
(541) 496-4546
(541) 496-8538
Mailing address
457 LONE ROCK RD, GLIDE, OR 97443-9779
(541) 496-4546
(541) 496-4625

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6527
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
080796
OR
Enumeration date
02/25/2008
Last updated
02/25/2008
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