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Individual

DR. JOHN WILLIAM HALLETT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
27482
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274820
SC
01
CH8347
RAILROAD MEDICARE GROUP
SC
01
P00193529
RAILROAD MEDICARE PIN
SC
01
P00739551
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
11/30/2005
Last updated
05/10/2016
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