Individual
MS. JENNIFER BACKER HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
380 HOSPITAL DR., SUITE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
P.O. BOX 2564, MACON, GA 31203-2564
(478) 746-5644
(478) 745-4849
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
BP10065734
TX
207L00000X
Anesthesiology Physician
Primary
T1714
TX
367H00000X
Anesthesiologist Assistant
003397
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003106353A
—
GA
05
—
00505788B
—
GA
Enumeration date
11/29/2006
Last updated
07/28/2021
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