Individual
DR. KATHRYN AZELIA HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,M.P.H, FACOG
Contact information
Practice address
227 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 720-7733
(770) 720-4557
Mailing address
227 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 720-7733
(770) 720-4557
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
31578
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
68542
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315787
—
SC
01
—
SCI6763365
MEDICARE PIN
SC
Enumeration date
04/10/2007
Last updated
10/29/2020
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