Individual
MR. CLAYTON REESE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7005 WALLACE RD STE 600, CHARLOTTE, NC 28212-6814
(704) 568-9133
Mailing address
7005 WALLACE RD STE 600, CHARLOTTE, NC 28212-6814
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07885
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-07885
NORTH CAROLINA MEDICAL BOARD
NC
Enumeration date
02/05/2018
Last updated
02/05/2018
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